| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
15,700 |
15,077 |
$944K |
| A4554 |
Disposable underpads, all sizes |
32,108 |
30,981 |
$883K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13,791 |
13,256 |
$779K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
8,534 |
8,158 |
$641K |
| A4245 |
Alcohol wipes, per box |
38,121 |
37,026 |
$484K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
12,852 |
12,433 |
$392K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
23,691 |
22,734 |
$300K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,199 |
2,116 |
$196K |
| E0570 |
Nebulizer, with compressor |
2,408 |
2,288 |
$159K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,109 |
2,043 |
$151K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,461 |
2,318 |
$129K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
785 |
756 |
$56K |
| A5120 |
Skin barrier, wipes or swabs, each |
6,167 |
6,024 |
$51K |
| A4927 |
Gloves, non-sterile, per 100 |
8,040 |
7,768 |
$38K |
| 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 |
274 |
273 |
$31K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,915 |
1,856 |
$23K |
| 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 |
106 |
92 |
$15K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
127 |
127 |
$5K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
137 |
137 |
$4K |
| S5199 |
Personal care item, nos, each |
96 |
82 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
402 |
369 |
$3K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,135 |
2,095 |
$2K |
| 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 |
15 |
12 |
$957.10 |
| T4541 |
Incontinence product, disposable underpad, large, each |
37 |
37 |
$908.92 |