| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
823 |
770 |
$274K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
381 |
373 |
$154K |
| A4322 |
Irrigation syringe, bulb or piston, each |
457 |
365 |
$92K |
| T4541 |
Incontinence product, disposable underpad, large, each |
456 |
417 |
$36K |
| A4927 |
Gloves, non-sterile, per 100 |
659 |
622 |
$18K |
| B9998 |
Noc for enteral supplies |
135 |
116 |
$16K |