| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
56,426 |
22,504 |
$692K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
15,417 |
7,165 |
$672K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
16,580 |
6,001 |
$595K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
16,092 |
5,203 |
$516K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
11,223 |
4,999 |
$475K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
21,233 |
6,176 |
$453K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
6,933 |
2,367 |
$414K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
5,286 |
2,285 |
$238K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
17,387 |
1,695 |
$224K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
14,277 |
2,955 |
$223K |
| A4305 |
Disposable drug delivery system, flow rate of 50 ml or greater per hour |
9,417 |
1,205 |
$219K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
7,460 |
849 |
$136K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
10,114 |
2,292 |
$79K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
1,181 |
265 |
$70K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
20,046 |
9,938 |
$65K |
| A4927 |
Gloves, non-sterile, per 100 |
19,780 |
9,808 |
$60K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
3,025 |
764 |
$53K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
3,340 |
800 |
$47K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
7,526 |
615 |
$47K |
| B9998 |
Noc for enteral supplies |
7,026 |
955 |
$41K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
9,602 |
1,497 |
$25K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
6,470 |
4,467 |
$14K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
277 |
166 |
$11K |
| A4332 |
Lubricant, individual sterile packet, each |
2,778 |
433 |
$5K |
| J2260 |
Injection, milrinone lactate, 5 mg |
133 |
37 |
$4K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,148 |
48 |
$3K |
| J1642 |
Injection, heparin sodium, (heparin lock flush), per 10 units |
6,973 |
1,144 |
$2K |
| B9002 |
Enteral nutrition infusion pump, any type |
14 |
12 |
$568.16 |