| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
73,662 |
68,846 |
$2.61M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,798 |
3,474 |
$2.24M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
32,120 |
30,409 |
$1.90M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
13,072 |
12,430 |
$1.75M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13,770 |
13,104 |
$1.61M |
| T4541 |
Incontinence product, disposable underpad, large, each |
36,364 |
34,752 |
$1.53M |
| 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 |
6,355 |
5,446 |
$1.32M |
| 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 |
9,160 |
7,977 |
$1.07M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
7,660 |
7,304 |
$1.02M |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
2,222 |
1,820 |
$1.00M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
7,130 |
6,727 |
$983K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
17,788 |
16,494 |
$839K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
26,357 |
14,910 |
$814K |
| 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 |
4,905 |
4,188 |
$650K |
| A4927 |
Gloves, non-sterile, per 100 |
32,704 |
30,047 |
$637K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
61,784 |
32,572 |
$578K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
7,602 |
6,308 |
$557K |
| 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 |
3,432 |
3,040 |
$541K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,431 |
3,175 |
$428K |
| B9998 |
Noc for enteral supplies |
3,056 |
1,123 |
$421K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,589 |
2,424 |
$374K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,398 |
1,229 |
$304K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,572 |
2,416 |
$280K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,436 |
1,191 |
$213K |
| B4100 |
Food thickener, administered orally, per ounce |
1,246 |
1,049 |
$181K |
| E1392 |
Portable oxygen concentrator, rental |
4,818 |
4,061 |
$174K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,684 |
1,582 |
$165K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,376 |
1,151 |
$132K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
2,790 |
1,671 |
$131K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
680 |
663 |
$125K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,215 |
1,059 |
$111K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,091 |
923 |
$106K |
| A4335 |
Incontinence supply; miscellaneous |
10,867 |
7,503 |
$82K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
1,925 |
1,651 |
$66K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,151 |
835 |
$62K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
982 |
829 |
$60K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
301 |
262 |
$57K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
376 |
320 |
$56K |
| A7031 |
Face mask interface, replacement for full face mask, each |
1,603 |
1,440 |
$55K |
| E0570 |
Nebulizer, with compressor |
2,373 |
1,948 |
$54K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
481 |
425 |
$40K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
356 |
239 |
$38K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
1,324 |
1,043 |
$32K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
254 |
239 |
$28K |
| A7035 |
Headgear used with positive airway pressure device |
1,373 |
1,189 |
$28K |
| A4322 |
Irrigation syringe, bulb or piston, each |
734 |
593 |
$25K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,995 |
1,473 |
$24K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,183 |
1,011 |
$23K |
| K0001 |
Standard wheelchair |
703 |
469 |
$22K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
4,591 |
4,143 |
$17K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,326 |
1,204 |
$16K |
| B9002 |
Enteral nutrition infusion pump, any type |
82 |
69 |
$15K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
988 |
874 |
$14K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
289 |
199 |
$13K |
| A4670 |
Automatic blood pressure monitor |
125 |
117 |
$13K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
389 |
355 |
$11K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,001 |
840 |
$11K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
949 |
723 |
$9K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
59 |
38 |
$9K |
| A7002 |
Tubing, used with suction pump, each |
1,368 |
1,258 |
$8K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
1,305 |
1,139 |
$7K |
| E0245 |
Tub stool or bench |
105 |
91 |
$7K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
28 |
25 |
$6K |
| K0003 |
Lightweight wheelchair |
187 |
108 |
$6K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
15 |
13 |
$5K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
576 |
509 |
$4K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
59 |
39 |
$4K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
28 |
24 |
$3K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
29 |
25 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
86 |
53 |
$2K |
| A7033 |
Pillow for use on nasal cannula type interface, replacement only, pair |
102 |
80 |
$2K |
| E0156 |
Seat attachment, walker |
147 |
100 |
$2K |
| K0004 |
High strength, lightweight wheelchair |
131 |
68 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
408 |
147 |
$1K |
| A4452 |
Tape, waterproof, per 18 square inches |
88 |
68 |
$972.12 |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
74 |
40 |
$949.77 |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
23 |
13 |
$920.23 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
95 |
86 |
$891.04 |
| E0244 |
Raised toilet seat |
15 |
15 |
$717.50 |
| A4402 |
Lubricant, per ounce |
38 |
36 |
$699.54 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
337 |
208 |
$682.27 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
27 |
16 |
$550.99 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
356 |
113 |
$432.36 |
| A7037 |
Tubing used with positive airway pressure device |
19 |
13 |
$402.90 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
36 |
26 |
$290.40 |
| A4332 |
Lubricant, individual sterile packet, each |
26 |
25 |
$236.27 |
| A4615 |
Cannula, nasal |
77 |
69 |
$210.00 |
| A4616 |
Tubing (oxygen), per foot |
17 |
13 |
$208.86 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
111 |
106 |
$197.63 |
| A4657 |
Syringe, with or without needle, each |
16 |
12 |
$186.48 |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
336 |
262 |
$152.02 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
38 |
24 |
$41.07 |