| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
286,714 |
285,574 |
$15.04M |
| A4554 |
Disposable underpads, all sizes |
538,206 |
536,270 |
$14.70M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
584,838 |
583,144 |
$11.76M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
326,290 |
325,285 |
$11.69M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
120,910 |
120,357 |
$7.08M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
32,670 |
32,447 |
$3.88M |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
23,169 |
12,177 |
$3.46M |
| E0241 |
Bath tub wall rail, each |
31,485 |
31,372 |
$3.21M |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
92,325 |
92,019 |
$2.91M |
| A4927 |
Gloves, non-sterile, per 100 |
540,957 |
539,442 |
$2.36M |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
48,419 |
48,267 |
$1.46M |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
22,814 |
11,948 |
$1.42M |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
63,642 |
63,330 |
$948K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
28,974 |
28,841 |
$756K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
11,905 |
11,852 |
$410K |
| A4670 |
Automatic blood pressure monitor |
8,620 |
8,501 |
$406K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
7,877 |
3,981 |
$346K |
| A4259 |
Lancets, per box of 100 |
61,321 |
61,074 |
$334K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
20,202 |
20,130 |
$327K |
| K0001 |
Standard wheelchair |
39,876 |
38,621 |
$314K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
6,594 |
3,314 |
$308K |
| L3410 |
Metatarsal bar wedge, between sole |
7,198 |
3,603 |
$304K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
8,051 |
7,825 |
$254K |
| 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 |
3,049 |
3,020 |
$226K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
2,769 |
2,750 |
$215K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
3,969 |
3,730 |
$184K |
| 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 |
1,261 |
1,245 |
$165K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,754 |
5,623 |
$163K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
15,074 |
14,637 |
$160K |
| L3215 |
Orthopedic footwear, ladies shoe, oxford, each |
3,130 |
1,748 |
$126K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
5,133 |
4,969 |
$115K |
| L3219 |
Orthopedic footwear, mens shoe, oxford, each |
2,260 |
1,265 |
$103K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
3,623 |
3,451 |
$85K |
| A4245 |
Alcohol wipes, per box |
58,891 |
58,703 |
$83K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
3,293 |
3,247 |
$78K |
| E1399 |
Durable medical equipment, miscellaneous |
6,395 |
6,249 |
$72K |
| A6537 |
Gradient compression stocking, full length/chap style, 30-40 mmhg, each |
132 |
121 |
$71K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
7,731 |
4,367 |
$70K |
| E0244 |
Raised toilet seat |
3,661 |
3,647 |
$69K |
| A4335 |
Incontinence supply; miscellaneous |
6,805 |
6,715 |
$67K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
1,765 |
1,705 |
$66K |
| 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 |
800 |
790 |
$66K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
5,644 |
5,539 |
$58K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
2,581 |
1,445 |
$56K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
1,562 |
1,542 |
$53K |
| E0156 |
Seat attachment, walker |
5,365 |
5,236 |
$53K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
376 |
340 |
$52K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
4,987 |
4,697 |
$48K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
29,307 |
28,390 |
$47K |
| K0003 |
Lightweight wheelchair |
4,155 |
3,914 |
$42K |
| A6540 |
Gradient compression stocking, waist length, 30-40 mmhg, each |
122 |
121 |
$41K |
| E0274 |
Over-bed table |
426 |
425 |
$37K |
| K0006 |
Heavy duty wheelchair |
1,601 |
1,555 |
$37K |
| E0243 |
Toilet rail, each |
261 |
261 |
$34K |
| E0277 |
Powered pressure-reducing air mattress |
447 |
411 |
$34K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
424 |
391 |
$34K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
1,242 |
1,146 |
$31K |
| K0007 |
Extra heavy duty wheelchair |
776 |
748 |
$31K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
4,328 |
4,199 |
$27K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
6,436 |
3,636 |
$26K |
| E1392 |
Portable oxygen concentrator, rental |
1,453 |
1,392 |
$24K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
4,073 |
3,854 |
$22K |
| E0570 |
Nebulizer, with compressor |
2,461 |
2,429 |
$21K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
1,247 |
1,214 |
$20K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
385 |
331 |
$17K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
404 |
345 |
$16K |
| K0004 |
High strength, lightweight wheelchair |
1,121 |
1,061 |
$15K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
139 |
134 |
$14K |
| L3480 |
Heel, pad and depression for spur |
486 |
247 |
$14K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
1,938 |
1,905 |
$14K |
| E0635 |
Patient lift, electric with seat or sling |
1,019 |
974 |
$12K |
| E0246 |
Transfer tub rail attachment |
83 |
83 |
$8K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
400 |
379 |
$8K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
170 |
169 |
$5K |
| E0245 |
Tub stool or bench |
205 |
205 |
$5K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
115 |
114 |
$5K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
1,311 |
1,240 |
$5K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
2,569 |
2,461 |
$5K |
| E0272 |
Mattress, foam rubber |
273 |
268 |
$4K |
| B4100 |
Food thickener, administered orally, per ounce |
83 |
82 |
$4K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
291 |
289 |
$4K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
372 |
354 |
$4K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
918 |
890 |
$4K |
| K0002 |
Standard hemi (low seat) wheelchair |
469 |
394 |
$4K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
292 |
279 |
$3K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
222 |
200 |
$3K |
| E2612 |
General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware |
48 |
36 |
$3K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
58 |
58 |
$3K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
330 |
313 |
$2K |
| E0621 |
Sling or seat, patient lift, canvas or nylon |
98 |
92 |
$2K |
| E2602 |
General use wheelchair seat cushion, width 22 inches or greater, any depth |
58 |
51 |
$1K |
| A6534 |
Gradient compression stocking, thigh length, 30-40 mmhg, each |
26 |
26 |
$1K |
| A4402 |
Lubricant, per ounce |
690 |
682 |
$1K |
| L3334 |
Lift, elevation, heel, per inch |
31 |
31 |
$1K |
| A4258 |
Spring-powered device for lancet, each |
214 |
212 |
$1K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
289 |
284 |
$787.64 |
| E1031 |
Rollabout chair, any and all types with casters 5" or greater |
200 |
173 |
$697.59 |
| L3320 |
Lift, elevation, heel and sole, cork, per inch |
12 |
12 |
$548.16 |
| E0607 |
Home blood glucose monitor |
17 |
17 |
$363.28 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
31 |
31 |
$176.97 |
| E0325 |
Urinal; male, jug-type, any material |
56 |
55 |
$145.41 |
| A6531 |
Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each |
12 |
12 |
$134.17 |
| A7015 |
Aerosol mask, used with dme nebulizer |
31 |
31 |
$9.10 |