| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
56,821 |
51,287 |
$5.00M |
| E1399 |
Durable medical equipment, miscellaneous |
4,099 |
3,895 |
$4.87M |
| A4554 |
Disposable underpads, all sizes |
54,416 |
52,610 |
$3.38M |
| 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 |
11,095 |
10,649 |
$2.70M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
17,395 |
16,890 |
$2.68M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
15,315 |
14,845 |
$2.60M |
| 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 |
25,376 |
24,107 |
$2.54M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
33,699 |
32,578 |
$2.49M |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
3,913 |
3,712 |
$2.38M |
| A4927 |
Gloves, non-sterile, per 100 |
70,746 |
68,775 |
$2.25M |
| E0190 |
Positioning cushion/pillow/wedge, any shape or size, includes all components and accessories |
7,634 |
3,299 |
$1.95M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
10,215 |
9,911 |
$1.67M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
6,726 |
6,498 |
$1.43M |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
1,302 |
1,269 |
$860K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
10,883 |
9,459 |
$821K |
| 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 |
2,673 |
2,552 |
$795K |
| B4102 |
Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
6,777 |
6,475 |
$704K |
| 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 |
3,888 |
3,696 |
$526K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,847 |
2,709 |
$408K |
| E0218 |
Fluid circulating cold pad with pump, any type |
1,185 |
1,162 |
$407K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,673 |
1,594 |
$395K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,776 |
2,652 |
$345K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
6,427 |
6,053 |
$309K |
| A4245 |
Alcohol wipes, per box |
8,939 |
8,736 |
$246K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
2,835 |
2,351 |
$228K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,893 |
2,805 |
$223K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,517 |
1,429 |
$216K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
322 |
278 |
$199K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
1,515 |
1,452 |
$197K |
| A4670 |
Automatic blood pressure monitor |
2,793 |
2,756 |
$197K |
| A4215 |
Needle, sterile, any size, each |
3,401 |
3,327 |
$145K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
7,204 |
6,840 |
$132K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
472 |
440 |
$124K |
| E0202 |
Phototherapy (bilirubin) light with photometer |
96 |
96 |
$85K |
| A4259 |
Lancets, per box of 100 |
5,735 |
5,576 |
$82K |
| E0245 |
Tub stool or bench |
1,549 |
1,536 |
$80K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
603 |
597 |
$76K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,787 |
1,751 |
$71K |
| E0243 |
Toilet rail, each |
916 |
886 |
$58K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
733 |
721 |
$56K |
| L0456 |
Tlso, flexible, provides trunk support, thoracic region, rigid posterior panel and soft anterior apron, extends from the sacrococcygeal junction and terminates just inferior to the scapular spine, restricts gross trunk motion in the sagittal plane, produces intracavitary pressure to reduce load on the intervertebral disks, includes straps and closures, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
66 |
66 |
$54K |
| E0241 |
Bath tub wall rail, each |
1,813 |
1,020 |
$53K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
678 |
669 |
$53K |
| E0274 |
Over-bed table |
453 |
444 |
$46K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
86 |
77 |
$43K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
1,596 |
1,569 |
$39K |
| E0607 |
Home blood glucose monitor |
613 |
588 |
$38K |
| E0315 |
Bed accessory: board, table, or support device, any type |
370 |
339 |
$36K |
| A6260 |
Wound cleansers, any type, any size |
1,623 |
1,554 |
$34K |
| E0156 |
Seat attachment, walker |
1,727 |
1,678 |
$25K |
| E0570 |
Nebulizer, with compressor |
837 |
818 |
$25K |
| E0560 |
Humidifier, durable for supplemental humidification during ippb treatment or oxygen delivery |
379 |
375 |
$24K |
| E0242 |
Bath tub rail, floor base |
194 |
187 |
$23K |
| E0244 |
Raised toilet seat |
799 |
783 |
$22K |
| K0003 |
Lightweight wheelchair |
490 |
482 |
$22K |
| A9281 |
Reaching/grabbing device, any type, any length, each |
1,066 |
1,045 |
$19K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,092 |
1,063 |
$19K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
184 |
177 |
$18K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
503 |
495 |
$18K |
| K0001 |
Standard wheelchair |
322 |
313 |
$15K |
| 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 |
26 |
25 |
$15K |
| E0305 |
Bed side rails, half length |
471 |
453 |
$13K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
3,282 |
3,167 |
$11K |
| E0246 |
Transfer tub rail attachment |
230 |
223 |
$11K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
320 |
311 |
$9K |
| E0720 |
Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation |
993 |
953 |
$8K |
| E0325 |
Urinal; male, jug-type, any material |
1,050 |
966 |
$6K |
| A6536 |
Gradient compression stocking, full length/chap style, 18-30 mmhg, each |
49 |
48 |
$5K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
473 |
467 |
$5K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
102 |
100 |
$3K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
80 |
80 |
$2K |
| A4663 |
Blood pressure cuff only |
116 |
103 |
$2K |
| E2603 |
Skin protection wheelchair seat cushion, width less than 22 inches, any depth |
13 |
13 |
$2K |
| E0271 |
Mattress, innerspring |
15 |
15 |
$2K |
| S8270 |
Enuresis alarm, using auditory buzzer and/or vibration device |
65 |
43 |
$2K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
73 |
72 |
$2K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
28 |
28 |
$1K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
47 |
44 |
$1K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
214 |
208 |
$1K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
18 |
14 |
$919.88 |
| A7015 |
Aerosol mask, used with dme nebulizer |
485 |
390 |
$869.12 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
178 |
169 |
$576.67 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
41 |
36 |
$482.28 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
13 |
12 |
$330.00 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
12 |
12 |
$256.50 |