| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
65,046 |
58,622 |
$1.31M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
14,577 |
13,629 |
$1.07M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12,747 |
11,987 |
$772K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
7,986 |
7,546 |
$725K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
29,996 |
28,040 |
$718K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
3,819 |
3,584 |
$484K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
5,654 |
5,357 |
$367K |
| A4335 |
Incontinence supply; miscellaneous |
92,173 |
81,575 |
$353K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
3,256 |
3,217 |
$278K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
13,991 |
11,445 |
$209K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,362 |
2,200 |
$146K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,716 |
1,630 |
$140K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,574 |
2,422 |
$138K |
| A4670 |
Automatic blood pressure monitor |
3,625 |
3,466 |
$138K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,459 |
2,256 |
$130K |
| 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 |
2,351 |
2,122 |
$127K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
420 |
262 |
$124K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,256 |
1,143 |
$115K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
878 |
753 |
$97K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
1,757 |
1,561 |
$91K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,482 |
1,409 |
$89K |
| 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 |
642 |
556 |
$63K |
| A4927 |
Gloves, non-sterile, per 100 |
12,489 |
11,337 |
$61K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,448 |
1,374 |
$56K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
602 |
555 |
$49K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
284 |
248 |
$46K |
| 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 |
280 |
254 |
$44K |
| E1399 |
Durable medical equipment, miscellaneous |
742 |
697 |
$43K |
| E2100 |
Blood glucose monitor with integrated voice synthesizer |
1,147 |
1,139 |
$43K |
| 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 |
271 |
255 |
$33K |
| A4259 |
Lancets, per box of 100 |
11,101 |
10,004 |
$31K |
| K0001 |
Standard wheelchair |
111 |
110 |
$29K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
290 |
282 |
$27K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
326 |
312 |
$27K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
280 |
235 |
$27K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
341 |
330 |
$27K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
230 |
222 |
$25K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
4,580 |
4,290 |
$24K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
433 |
419 |
$22K |
| A4245 |
Alcohol wipes, per box |
6,027 |
5,704 |
$21K |
| A4930 |
Gloves, sterile, per pair |
643 |
585 |
$20K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
347 |
334 |
$17K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
322 |
316 |
$17K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
414 |
324 |
$17K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
125 |
120 |
$16K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,066 |
1,020 |
$14K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
17,572 |
14,577 |
$14K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
251 |
228 |
$13K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
353 |
320 |
$13K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
441 |
425 |
$12K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
238 |
227 |
$11K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
206 |
194 |
$11K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
920 |
862 |
$9K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
835 |
812 |
$9K |
| E0248 |
Transfer bench, heavy duty, for tub or toilet with or without commode opening |
86 |
83 |
$8K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
106 |
100 |
$8K |
| A4452 |
Tape, waterproof, per 18 square inches |
643 |
424 |
$7K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
193 |
158 |
$7K |
| K0007 |
Extra heavy duty wheelchair |
55 |
54 |
$7K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
305 |
298 |
$6K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,023 |
854 |
$6K |
| E0244 |
Raised toilet seat |
285 |
260 |
$5K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
252 |
248 |
$5K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
337 |
219 |
$4K |
| E0156 |
Seat attachment, walker |
1,356 |
1,275 |
$4K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
178 |
115 |
$4K |
| A4456 |
Adhesive remover, wipes, any type, each |
600 |
446 |
$3K |
| A6252 |
Specialty absorptive 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 |
52 |
40 |
$3K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
413 |
370 |
$2K |
| A5120 |
Skin barrier, wipes or swabs, each |
439 |
397 |
$2K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
249 |
220 |
$2K |
| K0004 |
High strength, lightweight wheelchair |
22 |
21 |
$2K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
145 |
138 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
164 |
141 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
590 |
445 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
328 |
306 |
$2K |
| E0245 |
Tub stool or bench |
48 |
48 |
$1K |
| A4371 |
Ostomy skin barrier, powder, per oz |
264 |
258 |
$1K |
| A4663 |
Blood pressure cuff only |
123 |
116 |
$1K |
| E0607 |
Home blood glucose monitor |
436 |
292 |
$1K |
| A4256 |
Normal, low and high calibrator solution / chips |
667 |
636 |
$1K |
| A4402 |
Lubricant, per ounce |
307 |
227 |
$1K |
| B4100 |
Food thickener, administered orally, per ounce |
27 |
24 |
$986.98 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
212 |
183 |
$876.43 |
| A4258 |
Spring-powered device for lancet, each |
1,246 |
1,110 |
$876.27 |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
158 |
155 |
$825.37 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12 |
12 |
$790.23 |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
74 |
65 |
$517.82 |
| E0241 |
Bath tub wall rail, each |
51 |
27 |
$471.33 |
| A4322 |
Irrigation syringe, bulb or piston, each |
15 |
12 |
$220.87 |