| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
8,962 |
8,797 |
$602K |
| 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 |
1,075 |
1,030 |
$546K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
3,998 |
3,950 |
$522K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
8,822 |
8,655 |
$415K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,274 |
2,243 |
$383K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,904 |
1,866 |
$177K |
| A4927 |
Gloves, non-sterile, per 100 |
2,281 |
2,256 |
$35K |