| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
8,549 |
5,893 |
$1.07M |
| S5165 |
Home modifications; per service |
2,059 |
1,706 |
$699K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
6,109 |
5,934 |
$478K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,982 |
3,903 |
$454K |
| E1399 |
Durable medical equipment, miscellaneous |
3,905 |
2,585 |
$424K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,016 |
3,934 |
$404K |
| T4541 |
Incontinence product, disposable underpad, large, each |
6,201 |
6,033 |
$308K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,386 |
2,325 |
$304K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
598 |
577 |
$111K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
359 |
345 |
$101K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
660 |
641 |
$86K |
| A6532 |
Gradient compression stocking, below knee, 40-50 mmhg, used as a surgical dressing, each |
304 |
296 |
$78K |
| A4927 |
Gloves, non-sterile, per 100 |
1,829 |
1,795 |
$52K |
| 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 |
475 |
455 |
$52K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
49 |
48 |
$5K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12 |
12 |
$2K |
| A9270 |
Non-covered item or service |
214 |
175 |
$0.00 |