| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
5,090 |
5,075 |
$1.48M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
6,983 |
6,972 |
$1.16M |
| A4554 |
Disposable underpads, all sizes |
28,394 |
28,291 |
$1.07M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,623 |
4,618 |
$622K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,733 |
1,726 |
$495K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
9,301 |
9,261 |
$449K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
236 |
228 |
$415K |
| A4335 |
Incontinence supply; miscellaneous |
29,635 |
29,484 |
$160K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
113 |
109 |
$115K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
40 |
37 |
$65K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
395 |
389 |
$46K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
254 |
254 |
$28K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
115 |
115 |
$18K |
| 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 |
31 |
31 |
$11K |