| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
184,828 |
153,893 |
$20.13M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
101,753 |
99,802 |
$7.18M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
82,817 |
81,721 |
$6.69M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
66,836 |
65,427 |
$6.46M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
118,359 |
115,953 |
$6.45M |
| E1399 |
Durable medical equipment, miscellaneous |
22,771 |
19,619 |
$3.26M |
| T4541 |
Incontinence product, disposable underpad, large, each |
80,267 |
78,656 |
$2.75M |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
6,095 |
5,897 |
$1.03M |
| E0245 |
Tub stool or bench |
7,994 |
7,761 |
$957K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
7,191 |
7,033 |
$881K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
11,620 |
11,476 |
$845K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
4,236 |
4,079 |
$612K |
| 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 |
6,935 |
6,656 |
$553K |
| A4927 |
Gloves, non-sterile, per 100 |
22,222 |
21,643 |
$524K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
5,071 |
4,941 |
$476K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
2,324 |
2,313 |
$418K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
4,581 |
4,564 |
$367K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
4,719 |
4,474 |
$345K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
1,484 |
1,427 |
$282K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
5,026 |
4,942 |
$239K |
| 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 |
1,524 |
1,475 |
$225K |
| A4670 |
Automatic blood pressure monitor |
3,171 |
3,131 |
$189K |
| K0001 |
Standard wheelchair |
5,688 |
5,623 |
$150K |
| E0244 |
Raised toilet seat |
2,510 |
2,462 |
$116K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,326 |
1,289 |
$86K |
| S5165 |
Home modifications; per service |
26 |
24 |
$82K |
| E0156 |
Seat attachment, walker |
4,575 |
4,517 |
$66K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
611 |
578 |
$62K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
493 |
476 |
$45K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
228 |
228 |
$44K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
1,941 |
1,922 |
$39K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
454 |
450 |
$28K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
394 |
377 |
$27K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
455 |
451 |
$23K |
| K0800 |
Power operated vehicle, group 1 standard, patient weight capacity up to and including 300 pounds |
26 |
26 |
$22K |
| K0003 |
Lightweight wheelchair |
488 |
486 |
$20K |
| E0570 |
Nebulizer, with compressor |
1,704 |
1,690 |
$20K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
216 |
212 |
$19K |
| E0272 |
Mattress, foam rubber |
120 |
119 |
$19K |
| E0627 |
Seat lift mechanism, electric, any type |
78 |
69 |
$19K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
866 |
864 |
$13K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
429 |
429 |
$5K |
| V5266 |
Battery for use in hearing device |
57 |
57 |
$2K |
| E0210 |
Electric heat pad, standard |
30 |
30 |
$1K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
15 |
14 |
$531.56 |