| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
11,955 |
11,321 |
$3.70M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
14,616 |
14,201 |
$2.01M |
| T4541 |
Incontinence product, disposable underpad, large, each |
31,210 |
30,578 |
$1.54M |
| B9998 |
Noc for enteral supplies |
23,166 |
19,628 |
$1.54M |
| A4322 |
Irrigation syringe, bulb or piston, each |
18,477 |
18,197 |
$1.53M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
10,743 |
10,667 |
$1.12M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12,680 |
12,533 |
$1.08M |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
7,117 |
6,970 |
$909K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
1,320 |
1,314 |
$543K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
5,182 |
5,135 |
$465K |
| A7520 |
Tracheostomy/laryngectomy tube, non-cuffed, polyvinylchloride (pvc), silicone or equal, each |
1,987 |
1,958 |
$348K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,886 |
5,767 |
$335K |
| 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 |
1,836 |
1,412 |
$326K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
18,890 |
17,456 |
$312K |
| A6211 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
170 |
142 |
$290K |
| 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 |
379 |
329 |
$285K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
3,017 |
2,938 |
$223K |
| A4927 |
Gloves, non-sterile, per 100 |
11,042 |
10,914 |
$218K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,724 |
1,720 |
$202K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,471 |
3,389 |
$194K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
13,415 |
13,094 |
$170K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,761 |
1,716 |
$154K |
| A4657 |
Syringe, with or without needle, each |
17,701 |
11,680 |
$145K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
6,405 |
6,269 |
$133K |
| S9435 |
Medical foods for inborn errors of metabolism |
136 |
136 |
$130K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
2,382 |
2,368 |
$123K |
| A4624 |
Tracheal suction catheter, any type other than closed system, each |
1,502 |
1,451 |
$117K |
| Z5999 |
|
370 |
331 |
$107K |
| A7002 |
Tubing, used with suction pump, each |
6,733 |
6,659 |
$105K |
| A7000 |
Canister, disposable, used with suction pump, each |
6,081 |
5,907 |
$97K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
658 |
658 |
$95K |
| A4335 |
Incontinence supply; miscellaneous |
13,545 |
13,191 |
$82K |
| 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 |
529 |
419 |
$73K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
167 |
165 |
$72K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
587 |
584 |
$68K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
943 |
939 |
$68K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,411 |
1,405 |
$62K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
701 |
698 |
$62K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
329 |
329 |
$61K |
| T5999 |
Supply, not otherwise specified |
593 |
560 |
$54K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
1,354 |
1,348 |
$49K |
| K0001 |
Standard wheelchair |
932 |
725 |
$49K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
1,121 |
731 |
$45K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
483 |
436 |
$43K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
602 |
598 |
$41K |
| B9002 |
Enteral nutrition infusion pump, any type |
54 |
52 |
$35K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
564 |
564 |
$32K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
980 |
935 |
$26K |
| E0144 |
Walker, enclosed, four sided framed, rigid or folding, wheeled with posterior seat |
73 |
72 |
$17K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
475 |
475 |
$16K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,111 |
1,089 |
$14K |
| A4483 |
Moisture exchanger, disposable, for use with invasive mechanical ventilation |
165 |
165 |
$13K |
| A4402 |
Lubricant, per ounce |
2,693 |
2,691 |
$13K |
| A5120 |
Skin barrier, wipes or swabs, each |
871 |
855 |
$11K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,530 |
2,504 |
$9K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
803 |
789 |
$9K |
| A4332 |
Lubricant, individual sterile packet, each |
1,294 |
1,290 |
$8K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
129 |
128 |
$7K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,061 |
826 |
$7K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
38 |
36 |
$6K |
| A7525 |
Tracheostomy mask, each |
670 |
668 |
$6K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
88 |
88 |
$5K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
17 |
13 |
$5K |
| E0570 |
Nebulizer, with compressor |
70 |
70 |
$4K |
| J7131 |
Hypertonic saline solution, 1 ml |
88 |
87 |
$4K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
453 |
446 |
$4K |
| 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 |
16 |
12 |
$4K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
107 |
57 |
$2K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
24 |
24 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
102 |
52 |
$2K |
| A4371 |
Ostomy skin barrier, powder, per oz |
150 |
150 |
$1K |
| E0156 |
Seat attachment, walker |
84 |
83 |
$1K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
12 |
12 |
$595.05 |
| A7015 |
Aerosol mask, used with dme nebulizer |
240 |
238 |
$419.55 |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
12 |
12 |
$417.06 |
| A4215 |
Needle, sterile, any size, each |
28 |
27 |
$339.67 |
| A4670 |
Automatic blood pressure monitor |
12 |
12 |
$162.83 |