| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5199 |
Personal care item, nos, each |
106,380 |
84,458 |
$7.52M |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
9,028 |
8,060 |
$4.26M |
| A4554 |
Disposable underpads, all sizes |
53,078 |
48,968 |
$2.83M |
| 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 |
15,783 |
11,484 |
$2.17M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
25,395 |
22,969 |
$2.05M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
23,596 |
21,345 |
$2.02M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
17,859 |
16,072 |
$1.73M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
16,469 |
15,024 |
$1.26M |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
22,092 |
17,838 |
$1.18M |
| 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 |
7,770 |
5,417 |
$1.12M |
| A4927 |
Gloves, non-sterile, per 100 |
68,277 |
58,673 |
$1.10M |
| 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 |
9,945 |
7,913 |
$1.09M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
11,760 |
10,703 |
$1.06M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
5,262 |
4,773 |
$515K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
14,111 |
12,665 |
$505K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
9,011 |
8,485 |
$504K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
5,558 |
4,961 |
$418K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
4,519 |
3,723 |
$350K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
5,209 |
4,662 |
$305K |
| A4335 |
Incontinence supply; miscellaneous |
3,883 |
3,525 |
$249K |
| 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 |
1,133 |
790 |
$230K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
4,034 |
3,563 |
$211K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
4,112 |
3,861 |
$158K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,176 |
1,021 |
$155K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
1,122 |
987 |
$83K |
| A4332 |
Lubricant, individual sterile packet, each |
1,520 |
1,314 |
$82K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
1,367 |
1,289 |
$66K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
266 |
259 |
$51K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
707 |
625 |
$34K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
234 |
176 |
$26K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
859 |
758 |
$22K |
| A4371 |
Ostomy skin barrier, powder, per oz |
1,052 |
993 |
$18K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,628 |
1,509 |
$18K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
871 |
803 |
$16K |
| A4245 |
Alcohol wipes, per box |
546 |
511 |
$13K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
465 |
351 |
$11K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
567 |
448 |
$10K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
208 |
195 |
$10K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
358 |
307 |
$9K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
278 |
260 |
$9K |
| A5120 |
Skin barrier, wipes or swabs, each |
2,374 |
2,160 |
$6K |
| A4456 |
Adhesive remover, wipes, any type, each |
2,296 |
2,117 |
$5K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
797 |
747 |
$5K |
| A4322 |
Irrigation syringe, bulb or piston, each |
48 |
43 |
$3K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
369 |
329 |
$2K |
| T4541 |
Incontinence product, disposable underpad, large, each |
41 |
39 |
$2K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
68 |
64 |
$2K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
186 |
176 |
$1K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
48 |
39 |
$441.95 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
52 |
47 |
$242.96 |
| A4649 |
Surgical supply; miscellaneous |
13 |
12 |
$115.23 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
445 |
408 |
$24.18 |
| A9270 |
Non-covered item or service |
22 |
18 |
$0.00 |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
12 |
12 |
$0.00 |