| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
40,791 |
36,938 |
$1.44M |
| A4927 |
Gloves, non-sterile, per 100 |
88,598 |
79,604 |
$1.30M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
10,973 |
9,929 |
$968K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
8,505 |
7,662 |
$835K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
9,212 |
8,251 |
$825K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
18,531 |
16,792 |
$817K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
3,180 |
2,792 |
$722K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
6,542 |
5,962 |
$650K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
2,629 |
2,356 |
$608K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
5,117 |
4,464 |
$495K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
4,890 |
4,620 |
$472K |
| 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 |
3,841 |
3,224 |
$448K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
4,867 |
4,417 |
$439K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
4,105 |
3,581 |
$438K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
6,516 |
5,942 |
$327K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,498 |
2,213 |
$295K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
2,845 |
2,613 |
$278K |
| B4100 |
Food thickener, administered orally, per ounce |
1,374 |
1,143 |
$254K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
2,180 |
1,918 |
$209K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,868 |
1,176 |
$14K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
215 |
197 |
$9K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,556 |
1,401 |
$8K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
119 |
114 |
$7K |
| A4670 |
Automatic blood pressure monitor |
117 |
109 |
$5K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
692 |
501 |
$3K |
| A4402 |
Lubricant, per ounce |
748 |
674 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
96 |
96 |
$1K |
| A5120 |
Skin barrier, wipes or swabs, each |
290 |
274 |
$1K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
13 |
12 |
$1K |
| A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
209 |
191 |
$556.74 |
| A4259 |
Lancets, per box of 100 |
693 |
501 |
$211.80 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
78 |
62 |
$168.59 |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
13 |
12 |
$120.00 |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
73 |
63 |
$78.00 |