| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,097 |
4,080 |
$546K |
| A4554 |
Disposable underpads, all sizes |
13,025 |
12,940 |
$447K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,378 |
3,368 |
$375K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,245 |
2,217 |
$355K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,736 |
1,693 |
$150K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
612 |
603 |
$134K |
| A4335 |
Incontinence supply; miscellaneous |
15,713 |
15,196 |
$133K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,222 |
1,209 |
$119K |
| 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 |
432 |
427 |
$107K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
479 |
467 |
$58K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,931 |
1,874 |
$56K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,971 |
1,946 |
$11K |
| 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 |
12 |
12 |
$4K |
| B4100 |
Food thickener, administered orally, per ounce |
36 |
36 |
$3K |
| E0570 |
Nebulizer, with compressor |
14 |
14 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
14 |
14 |
$253.56 |