| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
53,172 |
35,989 |
$4.92M |
| T4541 |
Incontinence product, disposable underpad, large, each |
36,946 |
35,041 |
$1.34M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12,760 |
12,052 |
$1.31M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
11,232 |
10,717 |
$1.29M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
11,895 |
11,159 |
$1.18M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
3,956 |
3,786 |
$885K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
17,597 |
16,709 |
$834K |
| A4927 |
Gloves, non-sterile, per 100 |
49,677 |
46,942 |
$738K |
| 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 |
8,049 |
7,441 |
$593K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
3,447 |
3,249 |
$335K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
3,657 |
3,515 |
$302K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,559 |
2,441 |
$298K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,389 |
2,285 |
$247K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
3,896 |
2,078 |
$240K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,927 |
1,827 |
$214K |
| 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 |
1,889 |
1,730 |
$213K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,240 |
1,155 |
$112K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
996 |
925 |
$76K |
| E0245 |
Tub stool or bench |
1,851 |
1,779 |
$60K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
1,196 |
1,123 |
$60K |
| A4670 |
Automatic blood pressure monitor |
1,353 |
1,299 |
$52K |
| 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 |
361 |
331 |
$40K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
324 |
302 |
$28K |
| E0244 |
Raised toilet seat |
589 |
573 |
$25K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
895 |
838 |
$21K |
| K0001 |
Standard wheelchair |
426 |
414 |
$20K |
| E0570 |
Nebulizer, with compressor |
358 |
342 |
$11K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
112 |
110 |
$7K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
73 |
73 |
$6K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
841 |
752 |
$5K |
| E0156 |
Seat attachment, walker |
355 |
329 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
334 |
315 |
$1K |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
32 |
32 |
$231.67 |