| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
46,852 |
42,959 |
$1.32M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
23,200 |
22,661 |
$1.14M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
20,482 |
20,094 |
$1.00M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12,131 |
11,822 |
$723K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
10,467 |
10,291 |
$445K |
| A4245 |
Alcohol wipes, per box |
60,845 |
58,301 |
$391K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
5,113 |
5,003 |
$337K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
5,416 |
5,218 |
$330K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,513 |
2,244 |
$324K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,142 |
3,880 |
$303K |
| A4927 |
Gloves, non-sterile, per 100 |
47,117 |
44,686 |
$299K |
| A5120 |
Skin barrier, wipes or swabs, each |
13,899 |
11,879 |
$186K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,724 |
1,545 |
$164K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,454 |
2,359 |
$138K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,151 |
1,119 |
$131K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,693 |
1,666 |
$127K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
152 |
131 |
$89K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
859 |
736 |
$84K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,098 |
2,071 |
$64K |
| 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 |
605 |
587 |
$64K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
197 |
165 |
$40K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,916 |
1,861 |
$30K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
338 |
260 |
$29K |
| S5199 |
Personal care item, nos, each |
438 |
392 |
$24K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
454 |
304 |
$22K |
| E1399 |
Durable medical equipment, miscellaneous |
74 |
58 |
$17K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
298 |
232 |
$13K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
602 |
467 |
$13K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
167 |
149 |
$9K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,377 |
1,115 |
$8K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
337 |
281 |
$7K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
539 |
447 |
$7K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
77 |
67 |
$6K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
295 |
248 |
$6K |
| 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 |
29 |
25 |
$4K |
| A4371 |
Ostomy skin barrier, powder, per oz |
424 |
331 |
$3K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
38 |
37 |
$3K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
481 |
368 |
$2K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
25 |
24 |
$2K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
20 |
13 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
288 |
251 |
$1K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
18 |
12 |
$1K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
17 |
12 |
$1K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
389 |
314 |
$787.93 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
30 |
24 |
$533.34 |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
24 |
24 |
$232.00 |
| A6447 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard |
136 |
125 |
$134.52 |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
15 |
14 |
$36.92 |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
30 |
27 |
$26.00 |