| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
63,722 |
63,560 |
$2.93M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
46,703 |
45,569 |
$2.07M |
| A4217 |
Sterile water/saline, 500 ml |
11,418 |
10,196 |
$746K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
11,980 |
11,948 |
$621K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
7,135 |
6,411 |
$543K |
| A6255 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
4,550 |
4,090 |
$521K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
9,568 |
9,526 |
$401K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
11,949 |
10,694 |
$362K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
33,175 |
33,140 |
$353K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
5,152 |
5,123 |
$348K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
6,709 |
6,677 |
$334K |
| 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 |
751 |
706 |
$250K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
41,654 |
41,580 |
$229K |
| A6455 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to five inches, per yard |
1,133 |
1,066 |
$210K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
1,644 |
1,540 |
$139K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,427 |
2,413 |
$138K |
| A6211 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
261 |
246 |
$133K |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
2,280 |
2,026 |
$132K |
| A6447 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard |
1,334 |
1,251 |
$119K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,431 |
1,335 |
$101K |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
4,454 |
4,062 |
$93K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,653 |
1,634 |
$87K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,779 |
2,531 |
$80K |
| A4927 |
Gloves, non-sterile, per 100 |
4,447 |
4,206 |
$75K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,985 |
2,982 |
$73K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,760 |
1,757 |
$72K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
1,046 |
968 |
$72K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
186 |
179 |
$70K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,289 |
1,282 |
$54K |
| A4335 |
Incontinence supply; miscellaneous |
24,588 |
24,542 |
$48K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
377 |
357 |
$46K |
| E0245 |
Tub stool or bench |
847 |
845 |
$32K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
321 |
320 |
$22K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
121 |
117 |
$21K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,233 |
1,090 |
$21K |
| K0001 |
Standard wheelchair |
729 |
722 |
$21K |
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
63 |
62 |
$15K |
| A5120 |
Skin barrier, wipes or swabs, each |
823 |
781 |
$13K |
| A6210 |
Foam 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 |
84 |
80 |
$13K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
283 |
272 |
$10K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
301 |
275 |
$10K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
286 |
253 |
$7K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
78 |
76 |
$6K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
27 |
25 |
$6K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
77 |
66 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
76 |
76 |
$4K |
| E0570 |
Nebulizer, with compressor |
40 |
37 |
$4K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
101 |
93 |
$3K |
| A7035 |
Headgear used with positive airway pressure device |
136 |
135 |
$3K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
25 |
24 |
$3K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
101 |
90 |
$3K |
| A4389 |
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each |
43 |
12 |
$3K |
| V5008 |
Hearing screening |
146 |
145 |
$2K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
12 |
12 |
$2K |
| A7037 |
Tubing used with positive airway pressure device |
97 |
97 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
100 |
97 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
115 |
114 |
$2K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
13 |
13 |
$2K |
| 99244 |
Office or other outpatient consultation, moderate to high complexity |
25 |
25 |
$2K |
| V5014 |
Repair/modification of a hearing aid |
41 |
41 |
$2K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
17 |
17 |
$983.90 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
25 |
25 |
$769.65 |
| E0156 |
Seat attachment, walker |
91 |
91 |
$707.06 |
| A4456 |
Adhesive remover, wipes, any type, each |
62 |
61 |
$666.32 |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
14 |
14 |
$582.29 |
| V5264 |
Ear mold/insert, not disposable, any type |
13 |
13 |
$577.74 |
| 92567 |
|
25 |
25 |
$524.69 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
13 |
12 |
$253.23 |
| A7015 |
Aerosol mask, used with dme nebulizer |
102 |
99 |
$211.11 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
18 |
18 |
$190.40 |