| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,833 |
2,640 |
$275K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,479 |
2,193 |
$250K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
8,009 |
7,440 |
$200K |
| 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 |
2,159 |
1,844 |
$186K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,617 |
1,507 |
$150K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,587 |
2,398 |
$112K |
| 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 |
435 |
323 |
$50K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
622 |
399 |
$35K |
| A4927 |
Gloves, non-sterile, per 100 |
1,641 |
1,567 |
$31K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
68 |
64 |
$7K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
51 |
50 |
$6K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
50 |
48 |
$4K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
38 |
37 |
$4K |
| A4335 |
Incontinence supply; miscellaneous |
47 |
42 |
$25.00 |
| A9286 |
Hygienic item or device, disposable or non-disposable, any type, each |
475 |
466 |
$0.00 |