| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
114,908 |
101,470 |
$9.61M |
| A4927 |
Gloves, non-sterile, per 100 |
353,790 |
311,999 |
$9.26M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
71,322 |
62,746 |
$6.06M |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
151,360 |
129,428 |
$5.51M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
77,404 |
67,282 |
$5.44M |
| T4541 |
Incontinence product, disposable underpad, large, each |
113,849 |
100,043 |
$5.38M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
132,452 |
113,659 |
$3.54M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
13,275 |
11,217 |
$3.04M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
29,518 |
25,713 |
$2.76M |
| A4335 |
Incontinence supply; miscellaneous |
111,947 |
95,510 |
$2.69M |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
16,877 |
14,364 |
$2.53M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
30,287 |
26,492 |
$2.31M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
11,053 |
9,583 |
$668K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
7,400 |
6,459 |
$526K |
| 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 |
5,181 |
3,051 |
$242K |
| S9999 |
Sales tax |
9,038 |
7,819 |
$84K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
1,222 |
835 |
$24K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
3,048 |
2,232 |
$17K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
372 |
270 |
$14K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
505 |
302 |
$13K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
2,814 |
1,536 |
$6K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,523 |
1,059 |
$5K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
56 |
16 |
$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 |
16 |
13 |
$1K |
| A4245 |
Alcohol wipes, per box |
477 |
334 |
$494.49 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
47 |
26 |
$234.99 |
| A4259 |
Lancets, per box of 100 |
44 |
25 |
$20.65 |