| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
17,023 |
16,658 |
$1.37M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
6,559 |
6,404 |
$959K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
6,114 |
5,974 |
$687K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
4,036 |
3,934 |
$617K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
13,507 |
13,230 |
$457K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
6,403 |
6,158 |
$206K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
10,761 |
10,594 |
$192K |
| E0570 |
Nebulizer, with compressor |
2,175 |
2,173 |
$177K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,117 |
4,011 |
$101K |
| A4927 |
Gloves, non-sterile, per 100 |
17,399 |
17,027 |
$78K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
230 |
222 |
$21K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
184 |
184 |
$18K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
1,216 |
1,213 |
$16K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
324 |
163 |
$15K |
| 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 |
51 |
50 |
$9K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
95 |
93 |
$7K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
37 |
37 |
$5K |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,989 |
1,981 |
$2K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
53 |
53 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
113 |
107 |
$1K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
24 |
13 |
$689.44 |