| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
140,328 |
139,991 |
$5.25M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
67,409 |
67,202 |
$4.36M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
118,351 |
118,084 |
$4.29M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
60,326 |
60,178 |
$2.71M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
31,805 |
31,707 |
$2.25M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
9,396 |
9,357 |
$1.36M |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
22,741 |
22,692 |
$739K |
| A4927 |
Gloves, non-sterile, per 100 |
118,932 |
118,711 |
$518K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
8,343 |
8,330 |
$318K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
8,200 |
8,185 |
$215K |
| A4335 |
Incontinence supply; miscellaneous |
11,929 |
11,888 |
$74K |
| 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 |
1,164 |
1,161 |
$71K |
| E0241 |
Bath tub wall rail, each |
2,000 |
1,990 |
$64K |
| A4402 |
Lubricant, per ounce |
10,111 |
10,089 |
$60K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
1,556 |
1,554 |
$52K |
| E1399 |
Durable medical equipment, miscellaneous |
5,621 |
5,594 |
$52K |
| 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 |
454 |
451 |
$43K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
2,240 |
2,236 |
$42K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,251 |
1,244 |
$28K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
733 |
732 |
$19K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,853 |
1,845 |
$12K |
| E0244 |
Raised toilet seat |
229 |
228 |
$4K |
| E0245 |
Tub stool or bench |
92 |
92 |
$3K |
| A4259 |
Lancets, per box of 100 |
654 |
653 |
$2K |
| A4245 |
Alcohol wipes, per box |
599 |
598 |
$1K |
| E0243 |
Toilet rail, each |
14 |
14 |
$963.11 |
| 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 |
13 |
13 |
$882.71 |
| A5120 |
Skin barrier, wipes or swabs, each |
35 |
35 |
$285.44 |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
47 |
47 |
$0.00 |