| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
26,181 |
26,087 |
$1.47M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
13,956 |
13,635 |
$735K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
6,729 |
6,663 |
$665K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
6,223 |
6,177 |
$434K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,581 |
4,563 |
$408K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,839 |
4,819 |
$286K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
3,495 |
3,465 |
$247K |
| 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 |
1,372 |
1,345 |
$243K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,794 |
2,781 |
$240K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
746 |
744 |
$136K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
9,151 |
9,115 |
$132K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,529 |
3,513 |
$124K |
| A4335 |
Incontinence supply; miscellaneous |
8,821 |
8,745 |
$97K |
| 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 |
304 |
296 |
$50K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
3,040 |
2,976 |
$27K |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
39 |
39 |
$14K |
| A4927 |
Gloves, non-sterile, per 100 |
617 |
615 |
$10K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
80 |
75 |
$7K |