| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,788 |
2,607 |
$292K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,169 |
3,030 |
$285K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,688 |
2,604 |
$246K |
| A4927 |
Gloves, non-sterile, per 100 |
11,423 |
11,060 |
$242K |
| T4541 |
Incontinence product, disposable underpad, large, each |
11,718 |
11,165 |
$201K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,397 |
1,367 |
$148K |
| B4100 |
Food thickener, administered orally, per ounce |
1,208 |
1,061 |
$146K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,520 |
1,391 |
$120K |
| 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 |
2,023 |
1,864 |
$93K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
547 |
543 |
$58K |
| 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 |
526 |
472 |
$35K |
| A4335 |
Incontinence supply; miscellaneous |
2,808 |
2,590 |
$33K |
| 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 |
220 |
179 |
$7K |