| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
33,372 |
31,842 |
$1.96M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
17,332 |
16,447 |
$1.31M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
15,258 |
14,480 |
$1.28M |
| 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 |
10,373 |
9,438 |
$946K |
| 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 |
5,045 |
4,625 |
$643K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
5,669 |
5,363 |
$594K |
| A4335 |
Incontinence supply; miscellaneous |
8,994 |
8,550 |
$343K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
3,723 |
3,433 |
$323K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
7,230 |
5,977 |
$320K |
| A4554 |
Disposable underpads, all sizes |
5,592 |
5,237 |
$274K |
| 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 |
1,437 |
1,322 |
$142K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
3,338 |
3,091 |
$118K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,142 |
1,056 |
$112K |
| A4927 |
Gloves, non-sterile, per 100 |
6,539 |
6,021 |
$100K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
2,594 |
2,542 |
$91K |
| E1399 |
Durable medical equipment, miscellaneous |
6,684 |
6,426 |
$90K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
991 |
916 |
$71K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
505 |
445 |
$58K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,591 |
1,528 |
$53K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
1,098 |
1,086 |
$51K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
355 |
355 |
$44K |
| E0245 |
Tub stool or bench |
2,055 |
2,020 |
$41K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,176 |
1,155 |
$38K |
| A4670 |
Automatic blood pressure monitor |
1,305 |
1,261 |
$37K |
| B4100 |
Food thickener, administered orally, per ounce |
340 |
328 |
$26K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
683 |
677 |
$24K |
| E0241 |
Bath tub wall rail, each |
1,128 |
1,092 |
$19K |
| E0244 |
Raised toilet seat |
650 |
649 |
$16K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
948 |
896 |
$15K |
| E0246 |
Transfer tub rail attachment |
287 |
287 |
$12K |
| E1639 |
Scale, each |
335 |
319 |
$12K |
| K0001 |
Standard wheelchair |
1,631 |
1,486 |
$12K |
| K0002 |
Standard hemi (low seat) wheelchair |
962 |
873 |
$11K |
| E0156 |
Seat attachment, walker |
960 |
945 |
$11K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
836 |
834 |
$8K |
| T4541 |
Incontinence product, disposable underpad, large, each |
188 |
188 |
$8K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
62 |
58 |
$8K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
256 |
237 |
$6K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
718 |
638 |
$5K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
150 |
150 |
$4K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
66 |
66 |
$3K |
| E0277 |
Powered pressure-reducing air mattress |
65 |
52 |
$3K |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
84 |
80 |
$1K |
| E0272 |
Mattress, foam rubber |
52 |
52 |
$1K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
21 |
21 |
$643.35 |
| A9281 |
Reaching/grabbing device, any type, any length, each |
27 |
27 |
$180.36 |
| K0003 |
Lightweight wheelchair |
30 |
24 |
$116.65 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
12 |
12 |
$42.95 |