| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4534 |
Youth size pull-on |
6,293 |
6,230 |
$684K |
| B4035 |
Enteral feed supp pump per d |
3,440 |
3,317 |
$620K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
3,108 |
3,025 |
$554K |
| A4554 |
Disposable underpads |
11,550 |
11,375 |
$451K |
| B9002 |
Enter nutr inf pump any type |
3,880 |
3,731 |
$276K |
| T4530 |
Ped size brief/diaper lg |
2,969 |
2,908 |
$242K |
| A4239 |
Non-adju cgm supply allow |
5,528 |
4,986 |
$230K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,575 |
2,477 |
$227K |
| T4526 |
Adult size pull-on med |
1,817 |
1,803 |
$208K |
| B4034 |
Enter feed supkit syr by day |
1,286 |
1,255 |
$183K |
| T4522 |
Adult size brief/diaper med |
1,652 |
1,624 |
$157K |
| A4927 |
Non-sterile gloves |
1,796 |
1,747 |
$126K |
| K0553 |
Ther cgm supply allowance |
5,879 |
5,035 |
$101K |
| T4533 |
Youth size brief/diaper |
1,135 |
1,109 |
$100K |
| T4525 |
Adult size pull-on sm |
927 |
921 |
$98K |
| T4532 |
Ped size pull-on lg |
949 |
943 |
$95K |
| A4353 |
Intermittent urinary cath |
164 |
157 |
$89K |
| T4521 |
Adult size brief/diaper sm |
955 |
932 |
$79K |
| B4161 |
Ef ped hydrolyzed/amino acid |
136 |
108 |
$68K |
| B4152 |
Ef calorie dense>/=1.5kcal |
132 |
129 |
$21K |
| E2103 |
Non-adju cgm receiver/mon |
503 |
468 |
$17K |
| B4149 |
Ef blenderized foods |
24 |
24 |
$5K |
| E0776 |
Iv pole |
310 |
299 |
$5K |
| K0554 |
Ther cgm receiver/monitor |
200 |
182 |
$4K |