| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
53,954 |
52,159 |
$6.99M |
| A4554 |
Disposable underpads, all sizes |
141,318 |
135,531 |
$6.91M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
41,069 |
39,526 |
$4.84M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
33,356 |
32,083 |
$4.15M |
| A4927 |
Gloves, non-sterile, per 100 |
98,537 |
94,282 |
$3.56M |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
15,355 |
14,660 |
$2.84M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
7,283 |
6,948 |
$881K |
| 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 |
5,227 |
4,587 |
$649K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
5,522 |
5,278 |
$634K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
5,521 |
5,295 |
$617K |
| A4928 |
Surgical mask, per 20 |
4,286 |
4,152 |
$588K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,269 |
3,131 |
$580K |
| 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 |
6,757 |
5,873 |
$502K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,571 |
2,482 |
$298K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
7,902 |
6,774 |
$242K |
| 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 |
976 |
872 |
$98K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
372 |
344 |
$46K |
| A4335 |
Incontinence supply; miscellaneous |
63 |
62 |
$488.40 |