| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Gloves, non-sterile, per 100 |
52,033 |
51,792 |
$1.40M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
14,459 |
14,428 |
$1.35M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
11,082 |
11,027 |
$1.22M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
13,147 |
13,094 |
$1.17M |
| T4541 |
Incontinence product, disposable underpad, large, each |
27,834 |
27,704 |
$1.07M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
8,850 |
8,817 |
$1.07M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
8,060 |
8,016 |
$1.06M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
6,627 |
6,609 |
$875K |
| 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 |
5,996 |
5,939 |
$822K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
8,861 |
8,826 |
$776K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
10,155 |
10,098 |
$503K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,751 |
819 |
$417K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
19,937 |
19,897 |
$323K |
| B4100 |
Food thickener, administered orally, per ounce |
5,653 |
5,634 |
$294K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
2,079 |
2,067 |
$264K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,640 |
1,613 |
$217K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
4,612 |
4,561 |
$197K |
| K0001 |
Standard wheelchair |
6,638 |
6,570 |
$138K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,913 |
1,756 |
$132K |
| 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 |
939 |
931 |
$122K |
| E1399 |
Durable medical equipment, miscellaneous |
253 |
160 |
$102K |
| E0245 |
Tub stool or bench |
2,081 |
2,076 |
$85K |
| 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 |
677 |
668 |
$79K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,858 |
1,834 |
$55K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,205 |
1,199 |
$51K |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
3,573 |
3,551 |
$49K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
225 |
222 |
$48K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
16,621 |
16,492 |
$46K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
213 |
200 |
$45K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
296 |
295 |
$38K |
| K0006 |
Heavy duty wheelchair |
643 |
643 |
$33K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
361 |
259 |
$33K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,596 |
4,542 |
$32K |
| 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 |
264 |
261 |
$29K |
| A4670 |
Automatic blood pressure monitor |
504 |
504 |
$27K |
| K0002 |
Standard hemi (low seat) wheelchair |
849 |
845 |
$20K |
| E0570 |
Nebulizer, with compressor |
348 |
348 |
$19K |
| E0241 |
Bath tub wall rail, each |
382 |
359 |
$16K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
357 |
345 |
$15K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
363 |
292 |
$15K |
| E0244 |
Raised toilet seat |
282 |
280 |
$13K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
308 |
306 |
$12K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
868 |
662 |
$10K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,100 |
1,080 |
$6K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
55 |
52 |
$4K |
| E0147 |
Walker, heavy duty, multiple braking system, variable wheel resistance |
48 |
48 |
$4K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
468 |
465 |
$3K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
595 |
579 |
$3K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
13 |
12 |
$881.01 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
32 |
31 |
$845.40 |
| K0003 |
Lightweight wheelchair |
12 |
12 |
$730.75 |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
16 |
16 |
$584.45 |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
12 |
12 |
$526.29 |
| A4354 |
Insertion tray with drainage bag but without catheter |
37 |
37 |
$192.82 |
| E0156 |
Seat attachment, walker |
12 |
12 |
$170.34 |
| A4402 |
Lubricant, per ounce |
39 |
38 |
$143.29 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
12 |
12 |
$109.76 |
| K0019 |
Arm pad, replacement only, each |
12 |
12 |
$102.41 |
| A4217 |
Sterile water/saline, 500 ml |
13 |
13 |
$37.19 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
15 |
14 |
$23.36 |