| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
919 |
636 |
$1.27M |
| 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 |
404 |
352 |
$182K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,016 |
2,861 |
$181K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
808 |
767 |
$132K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,061 |
2,909 |
$131K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
815 |
789 |
$110K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
509 |
493 |
$70K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
168 |
164 |
$46K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
140 |
125 |
$32K |
| A4927 |
Gloves, non-sterile, per 100 |
2,291 |
2,158 |
$31K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
70 |
58 |
$7K |
| K0001 |
Standard wheelchair |
139 |
121 |
$6K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
56 |
53 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$2K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12 |
12 |
$1K |
| A4670 |
Automatic blood pressure monitor |
19 |
15 |
$1K |
| E0601 |
Continuous positive airway pressure (cpap) device |
16 |
13 |
$758.82 |