| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
9,847 |
8,760 |
$1.12M |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
8,899 |
8,333 |
$1.02M |
| 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 |
4,849 |
4,295 |
$846K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,887 |
5,040 |
$488K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,307 |
4,607 |
$463K |
| 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 |
3,146 |
2,696 |
$417K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,951 |
4,243 |
$398K |
| A4554 |
Disposable underpads, all sizes |
15,089 |
12,923 |
$398K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
2,786 |
2,616 |
$295K |
| A4927 |
Gloves, non-sterile, per 100 |
23,281 |
20,319 |
$290K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,625 |
3,848 |
$236K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,672 |
1,430 |
$129K |
| B4100 |
Food thickener, administered orally, per ounce |
981 |
849 |
$124K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,458 |
1,317 |
$92K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
662 |
591 |
$67K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
815 |
673 |
$67K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
731 |
593 |
$50K |
| A4259 |
Lancets, per box of 100 |
1,276 |
1,151 |
$17K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
31 |
24 |
$4K |