| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
616 |
357 |
$51K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
222 |
142 |
$35K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
1,578 |
976 |
$34K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
519 |
298 |
$31K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
438 |
234 |
$28K |
| A4927 |
Gloves, non-sterile, per 100 |
1,932 |
1,165 |
$19K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
779 |
474 |
$17K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
191 |
119 |
$15K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
206 |
129 |
$15K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
786 |
420 |
$12K |
| 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 |
465 |
205 |
$6K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
79 |
59 |
$6K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
34 |
31 |
$3K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
33 |
30 |
$1K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 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 |
82 |
37 |
$690.84 |
| T4541 |
Incontinence product, disposable underpad, large, each |
33 |
22 |
$0.00 |