| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,886 |
1,757 |
$101K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
658 |
631 |
$54K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,388 |
1,267 |
$47K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
436 |
420 |
$33K |
| A4927 |
Gloves, non-sterile, per 100 |
1,948 |
1,777 |
$27K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
279 |
261 |
$19K |
| 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 |
57 |
48 |
$5K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
14 |
12 |
$3K |
| E0570 |
Nebulizer, with compressor |
39 |
37 |
$650.48 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
42 |
37 |
$138.07 |