| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S5199 |
Personal care item, nos, each |
34,499 |
33,300 |
$2.09M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
8,327 |
8,098 |
$960K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
8,174 |
7,888 |
$943K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
7,790 |
7,582 |
$938K |
| A4554 |
Disposable underpads, all sizes |
20,039 |
19,450 |
$852K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
6,817 |
6,629 |
$679K |
| 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 |
3,011 |
2,793 |
$647K |
| 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 |
2,989 |
2,757 |
$557K |
| A4927 |
Gloves, non-sterile, per 100 |
35,840 |
34,602 |
$506K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,362 |
4,249 |
$484K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,733 |
2,616 |
$347K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,101 |
2,048 |
$237K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
4,722 |
3,822 |
$183K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,647 |
1,592 |
$177K |
| 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 |
490 |
485 |
$90K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
3,933 |
3,327 |
$86K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,286 |
1,239 |
$43K |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
441 |
262 |
$10K |
| A4259 |
Lancets, per box of 100 |
1,973 |
1,720 |
$9K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
16 |
12 |
$3K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
483 |
25 |
$2K |
| A4215 |
Needle, sterile, any size, each |
360 |
312 |
$1K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
1,025 |
657 |
$1K |
| 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 |
18 |
15 |
$980.50 |
| E0607 |
Home blood glucose monitor |
15 |
15 |
$365.68 |
| 91320 |
|
240 |
212 |
$0.00 |
| 0004A |
|
245 |
224 |
$0.00 |
| 90670 |
|
25 |
23 |
$0.00 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
1,149 |
1,081 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
1,605 |
1,443 |
$0.00 |
| 90686 |
|
1,039 |
929 |
$0.00 |
| 0134A |
|
75 |
66 |
$0.00 |
| 0064A |
|
68 |
52 |
$0.00 |
| 90480 |
|
262 |
207 |
$0.00 |
| 90674 |
|
262 |
237 |
$0.00 |
| 90656 |
|
262 |
232 |
$0.00 |
| 90688 |
|
30 |
29 |
$0.00 |
| G0009 |
Administration of pneumococcal vaccine |
26 |
23 |
$0.00 |