| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,009 |
989 |
$287K |
| A4554 |
Disposable underpads, all sizes |
2,239 |
2,195 |
$146K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,982 |
1,922 |
$83K |
| A4927 |
Gloves, non-sterile, per 100 |
1,929 |
1,864 |
$62K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
110 |
109 |
$42K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
1,119 |
1,089 |
$40K |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
123 |
123 |
$36K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
294 |
290 |
$15K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13 |
12 |
$2K |