| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
4,533 |
4,300 |
$877K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
14,511 |
10,152 |
$812K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
4,773 |
4,603 |
$736K |
| A4554 |
Disposable underpads, all sizes |
13,714 |
13,317 |
$648K |
| 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 |
2,952 |
2,825 |
$539K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,442 |
2,363 |
$351K |
| 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 |
1,341 |
1,284 |
$303K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,798 |
1,692 |
$275K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,238 |
2,162 |
$270K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
2,103 |
2,041 |
$254K |
| A4927 |
Gloves, non-sterile, per 100 |
21,804 |
20,994 |
$245K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,447 |
1,387 |
$184K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
1,357 |
1,279 |
$152K |
| E1399 |
Durable medical equipment, miscellaneous |
201 |
121 |
$151K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,145 |
1,063 |
$103K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
571 |
553 |
$75K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
617 |
567 |
$58K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
379 |
367 |
$17K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
338 |
315 |
$10K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
106 |
103 |
$8K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
854 |
807 |
$6K |
| B9998 |
Noc for enteral supplies |
99 |
96 |
$3K |
| A7002 |
Tubing, used with suction pump, each |
1,263 |
1,189 |
$3K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
12 |
12 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
39 |
36 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
679 |
649 |
$758.43 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
51 |
50 |
$696.00 |
| A4245 |
Alcohol wipes, per box |
103 |
98 |
$624.92 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
16 |
13 |
$364.68 |
| A4930 |
Gloves, sterile, per pair |
12 |
12 |
$289.00 |
| A7000 |
Canister, disposable, used with suction pump, each |
36 |
36 |
$201.34 |