| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
11,148 |
11,011 |
$832K |
| A4554 |
Disposable underpads, all sizes |
12,973 |
12,880 |
$461K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,455 |
3,441 |
$379K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
3,257 |
3,237 |
$294K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,586 |
1,582 |
$226K |
| 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 |
1,182 |
1,178 |
$221K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
5,473 |
5,454 |
$168K |
| 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 |
493 |
479 |
$125K |
| A4670 |
Automatic blood pressure monitor |
1,782 |
1,750 |
$100K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,356 |
2,302 |
$100K |
| A4335 |
Incontinence supply; miscellaneous |
16,938 |
16,829 |
$91K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
889 |
880 |
$85K |
| K0001 |
Standard wheelchair |
2,722 |
2,694 |
$55K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
287 |
287 |
$32K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
2,486 |
2,428 |
$29K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
892 |
886 |
$28K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
184 |
91 |
$23K |
| A7030 |
Full face mask used with positive airway pressure device, each |
286 |
280 |
$22K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
9,233 |
9,116 |
$16K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,317 |
1,311 |
$13K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
158 |
150 |
$11K |
| A7015 |
Aerosol mask, used with dme nebulizer |
9,226 |
9,114 |
$11K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
50 |
25 |
$10K |
| S1015 |
Iv tubing extension set |
386 |
363 |
$9K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
257 |
251 |
$7K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
56 |
54 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
699 |
690 |
$7K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
62 |
62 |
$6K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
60 |
54 |
$6K |
| A4209 |
Syringe with needle, sterile 5 cc or greater, each |
505 |
471 |
$6K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
177 |
173 |
$5K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
950 |
854 |
$5K |
| A7035 |
Headgear used with positive airway pressure device |
299 |
294 |
$4K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
199 |
188 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,101 |
1,083 |
$4K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
452 |
422 |
$4K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
183 |
172 |
$4K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
40 |
40 |
$3K |
| A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
101 |
90 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
476 |
449 |
$3K |
| A6203 |
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
295 |
278 |
$2K |
| A4259 |
Lancets, per box of 100 |
1,234 |
1,230 |
$1K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
13 |
13 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
25 |
25 |
$1K |
| K0003 |
Lightweight wheelchair |
131 |
131 |
$1K |
| A4245 |
Alcohol wipes, per box |
612 |
578 |
$977.61 |
| A7031 |
Face mask interface, replacement for full face mask, each |
27 |
27 |
$971.94 |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
149 |
147 |
$255.90 |
| A4248 |
Chlorhexidine containing antiseptic, 1 ml |
114 |
107 |
$232.84 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
12 |
12 |
$173.81 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
12 |
12 |
$74.40 |
| E0156 |
Seat attachment, walker |
38 |
38 |
$14.52 |
| 0001A |
|
24 |
24 |
$0.00 |
| 99401 |
|
13 |
13 |
$0.00 |
| 0013A |
|
16 |
16 |
$0.00 |
| 0002A |
|
23 |
23 |
$0.00 |
| 0003A |
|
20 |
20 |
$0.00 |