| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
9,387 |
8,413 |
$1.99M |
| T2028 |
Specialized supply, not otherwise specified, waiver |
4,556 |
4,055 |
$704K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
3,041 |
2,915 |
$378K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
944 |
814 |
$155K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,214 |
1,141 |
$139K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
937 |
887 |
$105K |
| 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 |
764 |
702 |
$102K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,246 |
1,091 |
$90K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
985 |
869 |
$82K |
| 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 |
453 |
424 |
$60K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
270 |
224 |
$51K |
| A4927 |
Gloves, non-sterile, per 100 |
1,819 |
1,727 |
$38K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
333 |
299 |
$33K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
404 |
367 |
$24K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
140 |
121 |
$15K |
| A4554 |
Disposable underpads, all sizes |
345 |
287 |
$11K |
| B4100 |
Food thickener, administered orally, per ounce |
38 |
37 |
$8K |
| A7000 |
Canister, disposable, used with suction pump, each |
541 |
516 |
$5K |
| B9002 |
Enteral nutrition infusion pump, any type |
37 |
24 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
473 |
450 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
85 |
85 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
243 |
234 |
$748.49 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
37 |
37 |
$80.55 |