| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
14,962 |
14,836 |
$521K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,413 |
3,366 |
$466K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,390 |
3,376 |
$439K |
| E0570 |
Nebulizer, with compressor |
3,374 |
3,315 |
$375K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,326 |
3,315 |
$374K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,420 |
1,368 |
$252K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,406 |
5,385 |
$218K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,139 |
1,115 |
$168K |
| A4335 |
Incontinence supply; miscellaneous |
16,251 |
16,104 |
$87K |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
6,339 |
6,260 |
$76K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
286 |
269 |
$23K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,370 |
1,333 |
$16K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
5,255 |
5,172 |
$10K |
| A7015 |
Aerosol mask, used with dme nebulizer |
5,257 |
5,175 |
$7K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
140 |
137 |
$4K |
| A4245 |
Alcohol wipes, per box |
1,355 |
1,346 |
$2K |
| A4259 |
Lancets, per box of 100 |
1,133 |
1,118 |
$2K |