| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
6,906 |
6,023 |
$245K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,316 |
5,379 |
$228K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
1,829 |
1,189 |
$220K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
760 |
644 |
$124K |
| A4927 |
Gloves, non-sterile, per 100 |
8,916 |
7,536 |
$117K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,927 |
1,658 |
$109K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,214 |
1,045 |
$92K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,325 |
1,065 |
$66K |
| 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 |
246 |
163 |
$19K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
165 |
128 |
$13K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
114 |
113 |
$3K |