| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
59,550 |
58,510 |
$9.94M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
11,221 |
10,841 |
$1.04M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
10,177 |
9,865 |
$1.01M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
8,599 |
8,425 |
$903K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
13,709 |
13,401 |
$832K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
4,065 |
3,888 |
$806K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
7,324 |
7,229 |
$800K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
4,689 |
4,652 |
$510K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,536 |
1,459 |
$461K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,722 |
3,606 |
$452K |
| 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 |
3,526 |
3,468 |
$451K |
| A4554 |
Disposable underpads, all sizes |
10,216 |
10,016 |
$428K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
4,296 |
4,183 |
$399K |
| A4927 |
Gloves, non-sterile, per 100 |
21,803 |
21,327 |
$300K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,838 |
2,626 |
$255K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,444 |
2,330 |
$214K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
2,417 |
2,335 |
$214K |
| 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 |
858 |
814 |
$179K |
| B9002 |
Enteral nutrition infusion pump, any type |
1,439 |
1,344 |
$143K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,323 |
1,299 |
$125K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
663 |
641 |
$77K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
738 |
728 |
$59K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
242 |
241 |
$24K |
| 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 |
77 |
72 |
$21K |
| A4259 |
Lancets, per box of 100 |
737 |
727 |
$14K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
106 |
99 |
$9K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
151 |
149 |
$8K |
| E0607 |
Home blood glucose monitor |
14 |
14 |
$2K |