| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5199 |
Personal care item, nos, each |
6,982 |
6,497 |
$384K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,248 |
2,149 |
$215K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,657 |
1,580 |
$159K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,549 |
1,466 |
$155K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,308 |
1,253 |
$98K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
823 |
803 |
$95K |
| A4554 |
Disposable underpads, all sizes |
3,698 |
3,360 |
$90K |
| E0570 |
Nebulizer, with compressor |
1,169 |
931 |
$41K |
| 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 |
262 |
234 |
$29K |
| A4927 |
Gloves, non-sterile, per 100 |
1,790 |
1,643 |
$26K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
99 |
98 |
$11K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
293 |
279 |
$6K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
175 |
125 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
12 |
12 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
163 |
162 |
$1K |
| K0001 |
Standard wheelchair |
212 |
152 |
$605.88 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
44 |
37 |
$169.72 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
15 |
12 |
$110.70 |