| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
57,563 |
54,832 |
$3.98M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
51,003 |
48,184 |
$3.44M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
34,825 |
33,050 |
$2.47M |
| A4554 |
Disposable underpads, all sizes |
86,348 |
78,540 |
$2.38M |
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
3,830 |
2,308 |
$2.13M |
| T4541 |
Incontinence product, disposable underpad, large, each |
37,977 |
33,170 |
$1.88M |
| 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 |
15,006 |
10,426 |
$1.67M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
34,624 |
32,644 |
$1.62M |
| E1399 |
Durable medical equipment, miscellaneous |
6,817 |
4,242 |
$1.58M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
18,210 |
16,691 |
$1.47M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
15,243 |
11,872 |
$1.45M |
| 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 |
14,809 |
12,208 |
$1.38M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
14,749 |
9,427 |
$1.24M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
17,450 |
15,590 |
$1.20M |
| S5199 |
Personal care item, nos, each |
91,732 |
79,758 |
$1.02M |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
3,365 |
1,842 |
$997K |
| A4927 |
Gloves, non-sterile, per 100 |
117,525 |
107,063 |
$957K |
| 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 |
6,952 |
5,494 |
$942K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
6,798 |
4,742 |
$915K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,485 |
829 |
$833K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12,716 |
10,494 |
$819K |
| 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 |
5,135 |
4,463 |
$680K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
7,938 |
3,574 |
$637K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
1,081 |
788 |
$510K |
| E0465 |
Home ventilator, any type, used with invasive interface, (e.g., tracheostomy tube) |
1,228 |
806 |
$497K |
| E0601 |
Continuous positive airway pressure (cpap) device |
11,144 |
8,715 |
$482K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
6,637 |
6,195 |
$446K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
4,085 |
3,737 |
$413K |
| B9998 |
Noc for enteral supplies |
7,115 |
3,974 |
$413K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
3,424 |
2,202 |
$368K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,377 |
3,103 |
$361K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
5,800 |
3,950 |
$342K |
| B9002 |
Enteral nutrition infusion pump, any type |
7,784 |
5,938 |
$332K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
12,462 |
9,588 |
$271K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
4,331 |
3,036 |
$269K |
| E0471 |
Respiratory assist device, bi-level pressure capability, with back-up rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
1,273 |
928 |
$268K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
5,864 |
4,327 |
$266K |
| E0466 |
Home ventilator, any type, used with non-invasive interface, (e.g., mask, chest shell) |
639 |
474 |
$260K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
4,091 |
2,549 |
$251K |
| K0001 |
Standard wheelchair |
9,334 |
6,979 |
$197K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
32,016 |
29,603 |
$179K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,185 |
1,526 |
$176K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
1,887 |
821 |
$175K |
| A4245 |
Alcohol wipes, per box |
20,897 |
20,016 |
$134K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
1,451 |
1,143 |
$129K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
2,322 |
1,759 |
$126K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
14,375 |
11,207 |
$119K |
| E0570 |
Nebulizer, with compressor |
2,630 |
2,088 |
$116K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
3,854 |
3,501 |
$111K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
1,878 |
1,344 |
$107K |
| B4157 |
Enteral formula, nutritionally complete, for special metabolic needs for inherited disease of metabolism, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
83 |
64 |
$101K |
| A4335 |
Incontinence supply; miscellaneous |
41,504 |
39,769 |
$99K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
1,860 |
1,173 |
$87K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
865 |
566 |
$82K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
380 |
251 |
$64K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,371 |
1,034 |
$63K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
5,676 |
3,955 |
$63K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
167 |
95 |
$61K |
| A5120 |
Skin barrier, wipes or swabs, each |
14,479 |
13,171 |
$60K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,141 |
550 |
$60K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
657 |
444 |
$59K |
| A4623 |
Tracheostomy, inner cannula |
1,158 |
615 |
$59K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
3,014 |
2,243 |
$56K |
| B4100 |
Food thickener, administered orally, per ounce |
816 |
621 |
$56K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
1,672 |
1,233 |
$53K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
2,572 |
1,966 |
$51K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
4,442 |
3,303 |
$48K |
| A7508 |
Housing and integrated adhesive, for use in a tracheostoma heat and moisture exchange system and/or with a tracheostoma valve, each |
1,376 |
854 |
$47K |
| E0619 |
Apnea monitor, with recording feature |
478 |
337 |
$44K |
| E1392 |
Portable oxygen concentrator, rental |
2,843 |
2,319 |
$41K |
| A4322 |
Irrigation syringe, bulb or piston, each |
1,825 |
1,153 |
$41K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
752 |
500 |
$38K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,255 |
2,782 |
$37K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,217 |
902 |
$37K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,657 |
1,108 |
$34K |
| A7526 |
Tracheostomy tube collar/holder, each |
2,356 |
1,344 |
$31K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
913 |
600 |
$31K |
| A9270 |
Non-covered item or service |
2,000 |
1,695 |
$30K |
| B4102 |
Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
103 |
100 |
$30K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
400 |
288 |
$29K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
511 |
307 |
$27K |
| A4452 |
Tape, waterproof, per 18 square inches |
911 |
545 |
$26K |
| E0565 |
Compressor, air power source for equipment which is not self-contained or cylinder driven |
1,703 |
1,284 |
$25K |
| E0277 |
Powered pressure-reducing air mattress |
217 |
141 |
$22K |
| T5999 |
Supply, not otherwise specified |
71 |
59 |
$20K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
591 |
414 |
$18K |
| E0550 |
Humidifier, durable for extensive supplemental humidification during ippb treatments or oxygen delivery |
851 |
616 |
$17K |
| K0006 |
Heavy duty wheelchair |
568 |
393 |
$17K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
448 |
197 |
$16K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
399 |
167 |
$16K |
| K0007 |
Extra heavy duty wheelchair |
274 |
197 |
$15K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,349 |
853 |
$15K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
393 |
217 |
$13K |
| E1235 |
Wheelchair, pediatric size, rigid, adjustable, with seating system |
171 |
98 |
$13K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
562 |
252 |
$12K |
| E0776 |
Iv pole |
1,466 |
1,086 |
$12K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,170 |
809 |
$11K |
| A7002 |
Tubing, used with suction pump, each |
2,980 |
1,939 |
$9K |
| K0003 |
Lightweight wheelchair |
331 |
221 |
$9K |
| A4618 |
Breathing circuits |
792 |
467 |
$9K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,083 |
672 |
$8K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
641 |
366 |
$8K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
683 |
486 |
$8K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,589 |
1,036 |
$8K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
288 |
159 |
$7K |
| E1060 |
Fully-reclining wheelchair, detachable arms, desk or full length, swing away detachable elevating legrests |
192 |
128 |
$6K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
127 |
63 |
$6K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
146 |
77 |
$5K |
| 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 |
35 |
24 |
$5K |
| A4371 |
Ostomy skin barrier, powder, per oz |
557 |
289 |
$5K |
| A7015 |
Aerosol mask, used with dme nebulizer |
3,316 |
2,552 |
$4K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
121 |
108 |
$4K |
| E0156 |
Seat attachment, walker |
225 |
148 |
$4K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
102 |
99 |
$3K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
1,444 |
789 |
$3K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
159 |
72 |
$3K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
62 |
36 |
$2K |
| A7010 |
Corrugated tubing, disposable, used with large volume nebulizer, 100 feet |
421 |
263 |
$2K |
| A7525 |
Tracheostomy mask, each |
947 |
600 |
$2K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
203 |
121 |
$2K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
15 |
12 |
$1K |
| A7007 |
Large volume nebulizer, disposable, unfilled, used with aerosol compressor |
436 |
263 |
$975.06 |
| E1031 |
Rollabout chair, any and all types with casters 5" or greater |
35 |
24 |
$895.19 |
| A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
230 |
169 |
$871.22 |
| E0245 |
Tub stool or bench |
39 |
30 |
$792.62 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
33 |
13 |
$758.62 |
| A4332 |
Lubricant, individual sterile packet, each |
141 |
75 |
$572.89 |
| A7012 |
Water collection device, used with large volume nebulizer |
189 |
111 |
$182.03 |
| A7037 |
Tubing used with positive airway pressure device |
23 |
14 |
$112.01 |
| A4244 |
Alcohol or peroxide, per pint |
28 |
12 |
$33.69 |