| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
28,332 |
19,002 |
$3.11M |
| T4541 |
Incontinence product, disposable underpad, large, each |
16,107 |
15,500 |
$609K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
5,234 |
4,987 |
$496K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,034 |
4,822 |
$493K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,189 |
4,007 |
$473K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
9,186 |
8,580 |
$430K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,744 |
1,643 |
$373K |
| 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 |
5,195 |
3,222 |
$315K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,842 |
2,704 |
$294K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,631 |
1,446 |
$171K |
| A4927 |
Gloves, non-sterile, per 100 |
9,053 |
8,433 |
$146K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
1,109 |
1,051 |
$124K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,060 |
1,024 |
$113K |
| 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 |
966 |
592 |
$96K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
399 |
386 |
$92K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
1,859 |
1,777 |
$89K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,741 |
2,448 |
$89K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
465 |
438 |
$50K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,802 |
1,646 |
$50K |
| 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 |
523 |
324 |
$48K |
| K0001 |
Standard wheelchair |
1,612 |
1,472 |
$38K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,446 |
1,299 |
$36K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,299 |
1,200 |
$23K |
| E0570 |
Nebulizer, with compressor |
2,305 |
2,143 |
$13K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
122 |
102 |
$8K |
| E0245 |
Tub stool or bench |
185 |
176 |
$8K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
494 |
455 |
$7K |
| E0244 |
Raised toilet seat |
67 |
61 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
79 |
69 |
$2K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
170 |
140 |
$2K |
| A4670 |
Automatic blood pressure monitor |
39 |
39 |
$1K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
225 |
153 |
$1K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
202 |
169 |
$902.04 |
| E0156 |
Seat attachment, walker |
82 |
77 |
$626.23 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
32 |
27 |
$235.73 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
135 |
116 |
$221.03 |
| E0627 |
Seat lift mechanism, electric, any type |
15 |
15 |
$146.03 |
| A7035 |
Headgear used with positive airway pressure device |
20 |
15 |
$59.44 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
18 |
14 |
$24.00 |