| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
296,206 |
295,749 |
$9.06M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
145,138 |
144,789 |
$8.88M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
292,862 |
291,936 |
$8.65M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
152,682 |
152,373 |
$6.52M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
71,417 |
71,203 |
$4.94M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
25,037 |
24,936 |
$3.39M |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
81,110 |
81,039 |
$2.10M |
| A4927 |
Gloves, non-sterile, per 100 |
315,569 |
315,232 |
$1.28M |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
29,268 |
29,208 |
$1.07M |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
19,493 |
19,466 |
$477K |
| A4335 |
Incontinence supply; miscellaneous |
113,117 |
113,065 |
$315K |
| 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 |
4,102 |
4,062 |
$306K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
5,913 |
5,912 |
$189K |
| E1399 |
Durable medical equipment, miscellaneous |
14,644 |
14,552 |
$179K |
| 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 |
1,445 |
1,439 |
$167K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
10,494 |
10,484 |
$160K |
| A4402 |
Lubricant, per ounce |
48,679 |
48,601 |
$158K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
8,740 |
8,715 |
$152K |
| A4670 |
Automatic blood pressure monitor |
3,026 |
3,018 |
$142K |
| E0241 |
Bath tub wall rail, each |
3,605 |
3,592 |
$108K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,937 |
1,923 |
$61K |
| 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 |
609 |
606 |
$57K |
| A4259 |
Lancets, per box of 100 |
7,690 |
7,672 |
$56K |
| V5266 |
Battery for use in hearing device |
3,380 |
3,371 |
$33K |
| E0244 |
Raised toilet seat |
1,540 |
1,538 |
$30K |
| A4245 |
Alcohol wipes, per box |
8,608 |
8,593 |
$12K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
151 |
151 |
$11K |
| B4100 |
Food thickener, administered orally, per ounce |
268 |
267 |
$10K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
384 |
383 |
$3K |
| E0245 |
Tub stool or bench |
98 |
98 |
$2K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
18 |
17 |
$331.00 |
| E0607 |
Home blood glucose monitor |
24 |
24 |
$305.53 |