| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
6,633 |
6,410 |
$1.64M |
| A5120 |
Skin barrier, wipes or swabs, each |
54,505 |
7,022 |
$1.15M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
4,159 |
4,093 |
$621K |
| A4554 |
Disposable underpads, all sizes |
9,905 |
9,743 |
$558K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
5,857 |
4,458 |
$515K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,531 |
1,497 |
$342K |
| 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 |
256 |
230 |
$276K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
2,562 |
2,499 |
$242K |
| A4927 |
Gloves, non-sterile, per 100 |
9,245 |
9,094 |
$189K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
1,503 |
1,491 |
$183K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
216 |
212 |
$135K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
462 |
460 |
$75K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
524 |
513 |
$60K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
569 |
562 |
$59K |
| B9002 |
Enteral nutrition infusion pump, any type |
758 |
735 |
$57K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
1,135 |
1,103 |
$54K |
| A4322 |
Irrigation syringe, bulb or piston, each |
1,125 |
1,110 |
$53K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
488 |
485 |
$51K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
322 |
319 |
$39K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
273 |
263 |
$36K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,451 |
1,423 |
$31K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
67 |
49 |
$20K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
588 |
582 |
$16K |
| E0570 |
Nebulizer, with compressor |
173 |
161 |
$15K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
24 |
24 |
$4K |
| 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 |
12 |
12 |
$3K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
102 |
102 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
204 |
194 |
$2K |
| A7015 |
Aerosol mask, used with dme nebulizer |
88 |
87 |
$126.71 |