| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
3,248 |
3,228 |
$471K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,741 |
2,700 |
$368K |
| B9998 |
Noc for enteral supplies |
2,200 |
1,297 |
$346K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
2,337 |
2,324 |
$326K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,561 |
2,556 |
$300K |
| T4541 |
Incontinence product, disposable underpad, large, each |
7,079 |
7,046 |
$267K |
| 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 |
1,829 |
1,810 |
$258K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,348 |
2,325 |
$224K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,462 |
2,457 |
$202K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,245 |
3,223 |
$168K |
| 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 |
851 |
844 |
$161K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
987 |
984 |
$140K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,324 |
1,315 |
$136K |
| A4927 |
Gloves, non-sterile, per 100 |
5,116 |
5,088 |
$118K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
940 |
930 |
$90K |
| A7030 |
Full face mask used with positive airway pressure device, each |
1,050 |
1,047 |
$79K |
| E0601 |
Continuous positive airway pressure (cpap) device |
2,211 |
2,195 |
$72K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
3,554 |
3,551 |
$58K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
386 |
384 |
$52K |
| E0570 |
Nebulizer, with compressor |
717 |
714 |
$38K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,457 |
1,452 |
$24K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
68 |
67 |
$23K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
700 |
698 |
$22K |
| A7031 |
Face mask interface, replacement for full face mask, each |
891 |
885 |
$21K |
| A7037 |
Tubing used with positive airway pressure device |
1,723 |
1,722 |
$18K |
| A7526 |
Tracheostomy tube collar/holder, each |
558 |
401 |
$18K |
| A7035 |
Headgear used with positive airway pressure device |
1,119 |
1,119 |
$15K |
| B9002 |
Enteral nutrition infusion pump, any type |
159 |
159 |
$13K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
113 |
113 |
$11K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
373 |
373 |
$9K |
| A7000 |
Canister, disposable, used with suction pump, each |
1,355 |
1,228 |
$7K |
| A4335 |
Incontinence supply; miscellaneous |
209 |
200 |
$7K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
383 |
383 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
2,137 |
2,134 |
$6K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
665 |
664 |
$5K |
| A7002 |
Tubing, used with suction pump, each |
1,836 |
1,672 |
$5K |
| A4217 |
Sterile water/saline, 500 ml |
163 |
163 |
$4K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
36 |
36 |
$3K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,060 |
1,058 |
$3K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
139 |
138 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
96 |
96 |
$2K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
215 |
215 |
$1K |
| A7525 |
Tracheostomy mask, each |
634 |
549 |
$1K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
78 |
66 |
$996.24 |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
377 |
367 |
$889.35 |
| B4100 |
Food thickener, administered orally, per ounce |
13 |
13 |
$826.64 |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
89 |
89 |
$751.39 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
17 |
17 |
$385.22 |
| A7012 |
Water collection device, used with large volume nebulizer |
61 |
61 |
$358.92 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
28 |
28 |
$262.00 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
30 |
30 |
$245.52 |
| A4452 |
Tape, waterproof, per 18 square inches |
16 |
15 |
$139.40 |
| A7015 |
Aerosol mask, used with dme nebulizer |
52 |
52 |
$68.40 |