| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,583 |
5,304 |
$705K |
| A4554 |
Disposable underpads, all sizes |
16,025 |
15,799 |
$603K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,555 |
5,362 |
$589K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,677 |
3,497 |
$548K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,975 |
2,777 |
$267K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,253 |
2,119 |
$225K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,487 |
1,420 |
$200K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,823 |
4,734 |
$154K |
| A4335 |
Incontinence supply; miscellaneous |
22,402 |
22,141 |
$152K |
| B4100 |
Food thickener, administered orally, per ounce |
1,150 |
1,095 |
$93K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
270 |
247 |
$60K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
78 |
65 |
$7K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
28 |
24 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
289 |
283 |
$3K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
18 |
12 |
$863.02 |