| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,341 |
4,315 |
$494K |
| A4554 |
Disposable underpads, all sizes |
13,869 |
13,736 |
$494K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,549 |
2,523 |
$253K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,731 |
1,722 |
$246K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,828 |
5,790 |
$205K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,384 |
1,365 |
$180K |
| A4335 |
Incontinence supply; miscellaneous |
16,230 |
16,027 |
$87K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
899 |
877 |
$84K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
123 |
123 |
$13K |
| 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 |
13 |
12 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
369 |
365 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
26 |
26 |
$374.90 |
| A4245 |
Alcohol wipes, per box |
164 |
160 |
$257.93 |
| A4259 |
Lancets, per box of 100 |
13 |
13 |
$32.82 |