| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
4,849 |
4,740 |
$4.29M |
| 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 |
9,055 |
8,961 |
$2.34M |
| 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 |
3,905 |
3,820 |
$539K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
3,544 |
3,532 |
$513K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,731 |
3,702 |
$339K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,131 |
3,090 |
$278K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,022 |
2,013 |
$248K |
| 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 |
1,651 |
1,609 |
$237K |
| A4927 |
Gloves, non-sterile, per 100 |
7,411 |
7,290 |
$217K |
| T4541 |
Incontinence product, disposable underpad, large, each |
6,042 |
5,988 |
$216K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,286 |
3,230 |
$171K |
| 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 |
657 |
637 |
$155K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,317 |
1,297 |
$138K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,150 |
1,102 |
$108K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
558 |
551 |
$86K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
704 |
701 |
$86K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
268 |
261 |
$44K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,982 |
1,972 |
$31K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
11,102 |
10,665 |
$29K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
193 |
192 |
$27K |
| E0245 |
Tub stool or bench |
608 |
607 |
$25K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
176 |
173 |
$21K |
| K0001 |
Standard wheelchair |
443 |
443 |
$21K |
| A4670 |
Automatic blood pressure monitor |
335 |
333 |
$18K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
350 |
348 |
$15K |
| E0849 |
Traction equipment, cervical, free-standing stand/frame, pneumatic, applying traction force to other than mandible |
113 |
113 |
$7K |
| A4500 |
Surgical stockings below knee length, each |
202 |
201 |
$6K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
404 |
226 |
$5K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
24 |
24 |
$5K |
| E0241 |
Bath tub wall rail, each |
72 |
72 |
$3K |
| E0156 |
Seat attachment, walker |
295 |
295 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$2K |
| E0570 |
Nebulizer, with compressor |
25 |
25 |
$1K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
75 |
75 |
$874.05 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
182 |
181 |
$782.13 |
| E0244 |
Raised toilet seat |
12 |
12 |
$729.12 |