| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
140,214 |
138,716 |
$7.46M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
94,444 |
90,360 |
$5.41M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
31,010 |
30,687 |
$3.17M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
55,809 |
55,247 |
$2.99M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
33,311 |
32,912 |
$2.09M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12,829 |
12,619 |
$1.16M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
11,619 |
11,493 |
$807K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
11,478 |
11,337 |
$718K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
12,227 |
12,057 |
$648K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
18,875 |
18,656 |
$491K |
| A4927 |
Gloves, non-sterile, per 100 |
32,662 |
31,873 |
$431K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
18,061 |
14,221 |
$219K |
| E0245 |
Tub stool or bench |
3,299 |
3,297 |
$192K |
| K0001 |
Standard wheelchair |
20,027 |
19,465 |
$169K |
| K0002 |
Standard hemi (low seat) wheelchair |
15,603 |
10,103 |
$118K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
8,786 |
7,467 |
$117K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,522 |
3,502 |
$87K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
1,260 |
1,242 |
$75K |
| K0816 |
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds |
3,839 |
1,979 |
$71K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
2,651 |
2,096 |
$69K |
| 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 |
752 |
685 |
$67K |
| K0003 |
Lightweight wheelchair |
5,027 |
4,999 |
$65K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
4,720 |
3,884 |
$64K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
4,276 |
4,267 |
$57K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,181 |
1,995 |
$52K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
13,258 |
12,574 |
$52K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
2,439 |
2,438 |
$52K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,779 |
1,621 |
$49K |
| E0184 |
Dry pressure mattress |
2,155 |
1,817 |
$47K |
| A4335 |
Incontinence supply; miscellaneous |
4,371 |
4,367 |
$40K |
| 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 |
779 |
715 |
$37K |
| 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 |
835 |
772 |
$25K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
2,096 |
1,992 |
$23K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
3,014 |
2,444 |
$21K |
| E0156 |
Seat attachment, walker |
5,665 |
4,565 |
$19K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
4,057 |
3,391 |
$18K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,481 |
3,463 |
$17K |
| E0277 |
Powered pressure-reducing air mattress |
604 |
441 |
$13K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
1,317 |
1,310 |
$13K |
| E0570 |
Nebulizer, with compressor |
8,276 |
7,796 |
$12K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
216 |
215 |
$11K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,328 |
3,668 |
$11K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
429 |
359 |
$11K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,430 |
718 |
$8K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
579 |
563 |
$8K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
489 |
372 |
$6K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
426 |
290 |
$6K |
| B9002 |
Enteral nutrition infusion pump, any type |
309 |
307 |
$5K |
| K0006 |
Heavy duty wheelchair |
615 |
379 |
$5K |
| K0007 |
Extra heavy duty wheelchair |
351 |
240 |
$4K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
507 |
211 |
$4K |
| A7000 |
Canister, disposable, used with suction pump, each |
622 |
586 |
$3K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
609 |
590 |
$3K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,146 |
635 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
272 |
258 |
$3K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
1,534 |
960 |
$3K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
921 |
871 |
$3K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
363 |
349 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
417 |
292 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
221 |
219 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
158 |
158 |
$2K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
174 |
106 |
$1K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
91 |
45 |
$1K |
| A7002 |
Tubing, used with suction pump, each |
581 |
553 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
163 |
163 |
$601.38 |
| E0776 |
Iv pole |
333 |
331 |
$450.92 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
82 |
76 |
$414.60 |
| E0305 |
Bed side rails, half length |
50 |
50 |
$410.65 |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
31 |
12 |
$377.28 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
768 |
616 |
$360.61 |
| A7015 |
Aerosol mask, used with dme nebulizer |
762 |
728 |
$329.15 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
194 |
135 |
$327.19 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
72 |
48 |
$261.64 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
416 |
343 |
$235.79 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
29 |
28 |
$122.02 |
| A7035 |
Headgear used with positive airway pressure device |
12 |
12 |
$73.29 |
| A4259 |
Lancets, per box of 100 |
56 |
51 |
$61.10 |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
25 |
25 |
$0.00 |