| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,566 |
1,515 |
$231K |
| 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 |
641 |
609 |
$182K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
3,571 |
2,843 |
$155K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
657 |
622 |
$113K |
| A5120 |
Skin barrier, wipes or swabs, each |
2,898 |
2,786 |
$112K |
| A4554 |
Disposable underpads, all sizes |
4,812 |
4,594 |
$111K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
491 |
472 |
$107K |
| A5122 |
Skin barrier; solid, 8 x 8 or equivalent, each |
6,119 |
5,816 |
$99K |
| A4930 |
Gloves, sterile, per pair |
2,438 |
2,295 |
$76K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
242 |
224 |
$51K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
109 |
108 |
$16K |
| A4927 |
Gloves, non-sterile, per 100 |
1,246 |
1,186 |
$3K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
12 |
12 |
$1K |
| A4335 |
Incontinence supply; miscellaneous |
87 |
50 |
$0.00 |