| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
12,546 |
11,673 |
$801K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,444 |
3,228 |
$472K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,256 |
3,056 |
$446K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,062 |
1,948 |
$358K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,633 |
1,438 |
$263K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,541 |
5,142 |
$247K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 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 |
1,328 |
1,167 |
$229K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
489 |
452 |
$123K |
| A4927 |
Gloves, non-sterile, per 100 |
9,738 |
9,080 |
$89K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
373 |
338 |
$40K |
| A4670 |
Automatic blood pressure monitor |
184 |
168 |
$11K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,271 |
1,111 |
$10K |
| A6534 |
Gradient compression stocking, thigh length, 30-40 mmhg, each |
51 |
46 |
$5K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
20 |
13 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
13 |
13 |
$16.82 |