| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| B4161 |
Enteral formula, for pediatrics, hydrolyzed/amino acids and peptide chain proteins, includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
35,173 |
34,473 |
$17.63M |
| 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 |
47,442 |
46,686 |
$7.99M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
26,564 |
26,379 |
$3.49M |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
22,911 |
22,630 |
$2.80M |
| 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 |
18,208 |
18,016 |
$2.08M |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
14,449 |
14,307 |
$2.00M |
| 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 |
15,894 |
15,746 |
$1.97M |
| 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 |
14,039 |
13,933 |
$1.79M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
20,991 |
20,530 |
$1.16M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
12,065 |
11,929 |
$1.16M |
| T4541 |
Incontinence product, disposable underpad, large, each |
27,150 |
26,832 |
$1.00M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
11,424 |
11,342 |
$980K |
| B4158 |
Enteral formula, for pediatrics, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber and/or iron, administered through an enteral feeding tube, 100 calories = 1 unit |
2,754 |
2,689 |
$878K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
7,681 |
7,526 |
$863K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
8,153 |
8,092 |
$739K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
5,019 |
4,970 |
$597K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,770 |
4,728 |
$510K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
4,278 |
4,191 |
$477K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
4,410 |
4,351 |
$477K |
| A4927 |
Gloves, non-sterile, per 100 |
17,991 |
17,877 |
$452K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,628 |
2,571 |
$329K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
14,845 |
14,689 |
$244K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
1,529 |
1,466 |
$244K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,924 |
1,797 |
$220K |
| B4100 |
Food thickener, administered orally, per ounce |
1,716 |
1,679 |
$216K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
70,574 |
67,378 |
$188K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
2,864 |
2,825 |
$184K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
643 |
634 |
$140K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
1,172 |
1,166 |
$133K |
| B4102 |
Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
1,524 |
1,495 |
$119K |
| A4670 |
Automatic blood pressure monitor |
1,644 |
1,641 |
$87K |
| E0245 |
Tub stool or bench |
1,284 |
1,282 |
$49K |
| B9998 |
Noc for enteral supplies |
145 |
145 |
$22K |
| B4103 |
Enteral formula, for pediatrics, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
265 |
257 |
$22K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
182 |
182 |
$5K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
403 |
397 |
$2K |
| A4210 |
Needle-free injection device, each |
27 |
27 |
$1K |
| E0156 |
Seat attachment, walker |
143 |
143 |
$1K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
14 |
12 |
$973.87 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
28 |
28 |
$415.47 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
13 |
12 |
$72.05 |