| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
673 |
659 |
$199K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,175 |
3,065 |
$186K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
3,341 |
3,240 |
$148K |
| A4554 |
Disposable underpads, all sizes |
5,206 |
5,067 |
$118K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,611 |
1,572 |
$104K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,765 |
2,686 |
$59K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
280 |
271 |
$35K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
792 |
760 |
$26K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
761 |
757 |
$26K |
| E0241 |
Bath tub wall rail, each |
702 |
688 |
$23K |
| A4670 |
Automatic blood pressure monitor |
415 |
413 |
$18K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
234 |
229 |
$18K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
395 |
382 |
$15K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
228 |
218 |
$14K |
| 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 |
181 |
168 |
$12K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
43 |
42 |
$4K |
| E0156 |
Seat attachment, walker |
153 |
150 |
$3K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
123 |
115 |
$2K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
104 |
97 |
$2K |
| E0246 |
Transfer tub rail attachment |
42 |
42 |
$2K |
| E0244 |
Raised toilet seat |
89 |
86 |
$2K |
| E0245 |
Tub stool or bench |
64 |
64 |
$2K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
133 |
132 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
230 |
215 |
$1K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
12 |
12 |
$907.28 |
| K0001 |
Standard wheelchair |
36 |
36 |
$714.17 |
| A4402 |
Lubricant, per ounce |
25 |
24 |
$179.04 |