| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
8,277 |
8,157 |
$1.34M |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
2,968 |
2,906 |
$671K |
| A4554 |
Disposable underpads, all sizes |
9,375 |
9,249 |
$301K |
| E0570 |
Nebulizer, with compressor |
2,560 |
2,500 |
$274K |
| A4335 |
Incontinence supply; miscellaneous |
9,720 |
9,582 |
$49K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
2,568 |
2,502 |
$46K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
101 |
95 |
$9K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
2,534 |
2,477 |
$7K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,568 |
2,502 |
$3K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
2,526 |
2,467 |
$3K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
109 |
108 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
262 |
244 |
$2K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12 |
12 |
$2K |