| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4035 |
Enteral feed supp pump per d |
16,076 |
4,304 |
$860K |
| T4522 |
Adult size brief/diaper med |
16,895 |
6,874 |
$741K |
| A4554 |
Disposable underpads |
19,868 |
12,634 |
$689K |
| T4523 |
Adult size brief/diaper lg |
6,964 |
4,046 |
$560K |
| T4524 |
Adult size brief/diaper xl |
5,731 |
2,968 |
$417K |
| T4543 |
Adult disp brief/diap abv xl |
2,202 |
1,266 |
$410K |
| B9998 |
Enteral supp not otherwise c |
15,048 |
3,525 |
$404K |
| T4527 |
Adult size pull-on lg |
4,258 |
2,574 |
$335K |
| T4528 |
Adult size pull-on xl |
2,830 |
1,671 |
$245K |
| T4521 |
Adult size brief/diaper sm |
9,277 |
2,584 |
$244K |
| T4533 |
Youth size brief/diaper |
28,268 |
2,592 |
$207K |
| T4526 |
Adult size pull-on med |
4,609 |
1,755 |
$196K |
| T4530 |
Ped size brief/diaper lg |
5,881 |
1,796 |
$175K |
| T4534 |
Youth size pull-on |
7,706 |
1,375 |
$149K |
| B4034 |
Enter feed supkit syr by day |
3,766 |
1,358 |
$140K |
| T4544 |
Adlt disp und/pull on abv xl |
1,139 |
714 |
$118K |
| B4088 |
Gastro/jejuno tube, low-pro |
864 |
546 |
$107K |
| A6250 |
Skin seal protect moisturizr |
16,996 |
13,375 |
$105K |
| T4532 |
Ped size pull-on lg |
2,193 |
549 |
$75K |
| T4525 |
Adult size pull-on sm |
1,715 |
477 |
$41K |
| A4927 |
Non-sterile gloves |
2,870 |
1,929 |
$34K |
| A7005 |
Nondisposable nebulizer set |
1,595 |
1,217 |
$23K |
| A4628 |
Oropharyngeal suction cath |
341 |
255 |
$22K |
| A7000 |
Disposable canister for pump |
1,014 |
593 |
$18K |
| A4335 |
Incontinence supply |
738 |
455 |
$15K |
| A7002 |
Tubing used w suction pump |
1,231 |
677 |
$8K |
| E0570 |
Nebulizer with compression |
24 |
22 |
$3K |
| A7015 |
Aerosol mask used w nebulize |
1,694 |
1,220 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
112 |
48 |
$316.03 |
| A7003 |
Nebulizer administration set |
31 |
12 |
$8.64 |