| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
36,668 |
36,189 |
$1.98M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12,048 |
11,885 |
$1.30M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
13,090 |
12,921 |
$1.21M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12,975 |
12,780 |
$1.08M |
| T4541 |
Incontinence product, disposable underpad, large, each |
21,835 |
21,255 |
$786K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
4,447 |
4,400 |
$744K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,792 |
3,785 |
$414K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
2,070 |
1,997 |
$369K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,140 |
1,138 |
$201K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,589 |
2,563 |
$186K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
6,940 |
6,813 |
$164K |
| 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 |
1,067 |
1,056 |
$156K |
| A4927 |
Gloves, non-sterile, per 100 |
4,556 |
4,499 |
$69K |
| E1399 |
Durable medical equipment, miscellaneous |
1,324 |
1,295 |
$60K |
| 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 |
183 |
177 |
$48K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
416 |
408 |
$43K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
409 |
409 |
$38K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
214 |
212 |
$26K |
| S5165 |
Home modifications; per service |
111 |
110 |
$14K |
| A4335 |
Incontinence supply; miscellaneous |
746 |
744 |
$8K |
| E0244 |
Raised toilet seat |
108 |
108 |
$8K |
| 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 |
33 |
32 |
$8K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
196 |
196 |
$6K |
| E0246 |
Transfer tub rail attachment |
52 |
52 |
$4K |
| E0570 |
Nebulizer, with compressor |
27 |
27 |
$2K |
| K0001 |
Standard wheelchair |
12 |
12 |
$273.32 |