| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
75,738 |
74,212 |
$9.54M |
| 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 |
34,877 |
32,885 |
$4.86M |
| B4100 |
Food thickener, administered orally, per ounce |
37,614 |
35,421 |
$2.67M |
| 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 |
14,647 |
13,383 |
$2.07M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
8,766 |
8,505 |
$942K |
| 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 |
3,142 |
2,968 |
$646K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,162 |
5,044 |
$592K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
4,155 |
4,093 |
$439K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
3,755 |
3,712 |
$437K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
3,843 |
3,738 |
$401K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
3,436 |
3,289 |
$390K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
3,062 |
3,012 |
$361K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
3,055 |
2,939 |
$249K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
2,150 |
2,073 |
$215K |
| A4554 |
Disposable underpads, all sizes |
4,047 |
3,945 |
$191K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,726 |
1,700 |
$187K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,005 |
971 |
$112K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
355 |
334 |
$23K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
180 |
179 |
$17K |
| A4927 |
Gloves, non-sterile, per 100 |
1,392 |
1,352 |
$11K |
| 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 |
40 |
40 |
$8K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
41 |
41 |
$910.08 |