| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
24,570 |
23,431 |
$1.36M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
8,799 |
8,456 |
$852K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
6,990 |
6,688 |
$774K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
7,974 |
7,644 |
$657K |
| T4541 |
Incontinence product, disposable underpad, large, each |
16,707 |
15,770 |
$646K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,821 |
1,732 |
$294K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
1,261 |
1,185 |
$242K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,727 |
1,719 |
$212K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,654 |
2,653 |
$186K |
| 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 |
1,328 |
1,282 |
$147K |
| 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 |
965 |
919 |
$130K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,481 |
1,396 |
$100K |
| A4927 |
Gloves, non-sterile, per 100 |
5,262 |
5,054 |
$92K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
353 |
336 |
$57K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
346 |
331 |
$37K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
279 |
242 |
$36K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
380 |
369 |
$29K |
| A4335 |
Incontinence supply; miscellaneous |
1,358 |
1,298 |
$21K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,574 |
1,574 |
$17K |
| E1399 |
Durable medical equipment, miscellaneous |
207 |
203 |
$16K |
| K0001 |
Standard wheelchair |
524 |
524 |
$13K |
| S5161 |
Emergency response system; service fee, per month (excludes installation and testing) |
333 |
332 |
$12K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
423 |
421 |
$10K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
202 |
202 |
$7K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
53 |
53 |
$4K |
| E0601 |
Continuous positive airway pressure (cpap) device |
41 |
41 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
158 |
158 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
544 |
544 |
$854.42 |
| E0570 |
Nebulizer, with compressor |
12 |
12 |
$567.60 |
| A7030 |
Full face mask used with positive airway pressure device, each |
12 |
12 |
$522.90 |