| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,298 |
1,264 |
$98K |
| A4554 |
Disposable underpads, all sizes |
369 |
356 |
$23K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
214 |
213 |
$19K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
424 |
403 |
$16K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
362 |
353 |
$13K |
| B4100 |
Food thickener, administered orally, per ounce |
175 |
173 |
$10K |
| 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 |
180 |
171 |
$5K |
| 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 |
56 |
50 |
$2K |