| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
3,207 |
3,056 |
$431K |
| A4554 |
Disposable underpads, all sizes |
11,658 |
11,297 |
$427K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,168 |
4,044 |
$358K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,753 |
3,659 |
$303K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
6,218 |
4,924 |
$287K |
| B9998 |
Noc for enteral supplies |
1,240 |
1,003 |
$242K |
| A4927 |
Gloves, non-sterile, per 100 |
21,536 |
19,403 |
$233K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,091 |
2,026 |
$212K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,501 |
2,403 |
$203K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,775 |
1,704 |
$197K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,561 |
1,508 |
$145K |
| 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 |
866 |
816 |
$142K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
608 |
586 |
$115K |
| A4335 |
Incontinence supply; miscellaneous |
1,703 |
1,502 |
$109K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
824 |
808 |
$106K |
| A4245 |
Alcohol wipes, per box |
8,305 |
8,055 |
$106K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
773 |
755 |
$79K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
749 |
730 |
$78K |
| 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 |
335 |
326 |
$70K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
682 |
607 |
$66K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,100 |
1,066 |
$54K |
| B9002 |
Enteral nutrition infusion pump, any type |
733 |
723 |
$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 |
221 |
211 |
$46K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
564 |
423 |
$45K |
| S5199 |
Personal care item, nos, each |
2,448 |
2,231 |
$34K |
| A4322 |
Irrigation syringe, bulb or piston, each |
360 |
332 |
$24K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
103 |
101 |
$10K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
500 |
376 |
$10K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
506 |
394 |
$7K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
43 |
38 |
$5K |
| K0001 |
Standard wheelchair |
479 |
347 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
850 |
573 |
$4K |
| K0003 |
Lightweight wheelchair |
150 |
103 |
$3K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
66 |
63 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
109 |
103 |
$703.15 |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
31 |
24 |
$686.40 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
87 |
73 |
$351.46 |
| A4402 |
Lubricant, per ounce |
15 |
14 |
$24.46 |