| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
9,118 |
9,107 |
$1.01M |
| A4554 |
Disposable underpads, all sizes |
21,091 |
21,063 |
$802K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
6,562 |
6,550 |
$634K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,558 |
4,542 |
$595K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
11,862 |
11,655 |
$374K |
| A4335 |
Incontinence supply; miscellaneous |
25,135 |
25,075 |
$139K |
| 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 |
499 |
497 |
$128K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,078 |
1,076 |
$114K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
694 |
682 |
$90K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
462 |
461 |
$79K |
| B9998 |
Noc for enteral supplies |
482 |
316 |
$71K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
258 |
243 |
$68K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
10,657 |
10,629 |
$60K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
573 |
569 |
$55K |
| 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 |
260 |
253 |
$55K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
459 |
459 |
$41K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
492 |
490 |
$25K |
| K0001 |
Standard wheelchair |
928 |
926 |
$23K |
| E0570 |
Nebulizer, with compressor |
371 |
371 |
$19K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,309 |
1,259 |
$18K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
103 |
103 |
$16K |
| A4670 |
Automatic blood pressure monitor |
177 |
176 |
$10K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
24 |
24 |
$6K |
| A7000 |
Canister, disposable, used with suction pump, each |
197 |
196 |
$6K |
| K0003 |
Lightweight wheelchair |
317 |
316 |
$6K |
| E0144 |
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat |
25 |
25 |
$4K |
| A4259 |
Lancets, per box of 100 |
1,085 |
1,070 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
201 |
201 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
84 |
84 |
$3K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
361 |
248 |
$2K |
| A4322 |
Irrigation syringe, bulb or piston, each |
222 |
222 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
164 |
163 |
$1K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
104 |
104 |
$874.65 |
| A4927 |
Gloves, non-sterile, per 100 |
135 |
131 |
$824.41 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
307 |
307 |
$691.89 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
12 |
12 |
$405.93 |
| E0156 |
Seat attachment, walker |
86 |
86 |
$359.61 |
| A7015 |
Aerosol mask, used with dme nebulizer |
277 |
277 |
$343.80 |