| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
30,852 |
28,792 |
$2.51M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
28,762 |
26,664 |
$2.19M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
13,100 |
11,994 |
$1.12M |
| A4554 |
Disposable underpads, all sizes |
70,183 |
63,829 |
$1.01M |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
7,377 |
6,738 |
$594K |
| A5120 |
Skin barrier, wipes or swabs, each |
82,710 |
75,518 |
$577K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
10,035 |
9,385 |
$390K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
2,817 |
2,449 |
$376K |
| S5199 |
Personal care item, nos, each |
10,299 |
8,731 |
$280K |
| 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 |
2,247 |
2,128 |
$272K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,426 |
3,125 |
$270K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,536 |
2,277 |
$239K |
| A4927 |
Gloves, non-sterile, per 100 |
36,640 |
31,905 |
$225K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,659 |
1,543 |
$219K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,922 |
1,799 |
$153K |
| 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 |
1,039 |
853 |
$70K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
180 |
173 |
$33K |
| 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 |
302 |
299 |
$23K |
| 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 |
658 |
456 |
$15K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
64 |
62 |
$6K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
26 |
24 |
$3K |