| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
50,875 |
49,456 |
$3.11M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
45,369 |
44,115 |
$2.62M |
| A4554 |
Disposable underpads, all sizes |
86,665 |
84,212 |
$1.41M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
20,779 |
20,043 |
$1.38M |
| A4335 |
Incontinence supply; miscellaneous |
34,177 |
32,637 |
$992K |
| A4245 |
Alcohol wipes, per box |
33,842 |
33,410 |
$858K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
19,509 |
18,908 |
$720K |
| A5120 |
Skin barrier, wipes or swabs, each |
53,622 |
51,408 |
$557K |
| S5199 |
Personal care item, nos, each |
16,845 |
14,993 |
$534K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
7,953 |
7,671 |
$513K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
6,826 |
6,579 |
$480K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
7,430 |
7,204 |
$415K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,228 |
4,042 |
$234K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
2,366 |
2,252 |
$225K |
| A4927 |
Gloves, non-sterile, per 100 |
66,056 |
64,088 |
$218K |
| 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 |
3,113 |
2,494 |
$194K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,934 |
1,872 |
$179K |
| 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 |
1,333 |
922 |
$74K |
| 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 |
1,600 |
988 |
$68K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,163 |
1,127 |
$52K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
14,821 |
14,376 |
$41K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
371 |
371 |
$14K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
626 |
617 |
$13K |