| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
48,395 |
38,958 |
$13.27M |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
9,162 |
7,838 |
$4.32M |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
21,564 |
18,019 |
$3.97M |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
7,809 |
6,713 |
$3.81M |
| E0784 |
External ambulatory infusion pump, insulin |
2,727 |
1,939 |
$3.24M |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
14,986 |
10,134 |
$2.52M |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
6,772 |
5,268 |
$1.58M |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
2,504 |
2,117 |
$893K |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
25,621 |
17,592 |
$869K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
12,444 |
9,749 |
$720K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
6,894 |
5,425 |
$644K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
8,629 |
7,037 |
$585K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
3,475 |
2,868 |
$538K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
10,911 |
7,935 |
$502K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
4,547 |
3,418 |
$456K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
28,063 |
17,417 |
$446K |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
3,186 |
2,426 |
$441K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
4,249 |
3,344 |
$393K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
5,523 |
4,319 |
$346K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
7,705 |
6,178 |
$304K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
7,208 |
5,909 |
$256K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
8,586 |
6,974 |
$247K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
2,779 |
2,232 |
$209K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
4,042 |
3,306 |
$205K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
7,132 |
6,177 |
$197K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
1,515 |
999 |
$193K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
1,634 |
1,309 |
$168K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
7,693 |
6,097 |
$159K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
296 |
236 |
$151K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
2,877 |
2,265 |
$148K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
355 |
277 |
$135K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
4,503 |
3,774 |
$128K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,051 |
959 |
$110K |
| T4541 |
Incontinence product, disposable underpad, large, each |
5,089 |
3,431 |
$110K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
1,512 |
1,119 |
$100K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
1,464 |
863 |
$99K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
593 |
394 |
$96K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
1,982 |
1,462 |
$92K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,816 |
1,452 |
$88K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
697 |
555 |
$83K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
881 |
537 |
$78K |
| A4456 |
Adhesive remover, wipes, any type, each |
10,762 |
8,743 |
$77K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
5,897 |
4,836 |
$75K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,713 |
1,021 |
$69K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,294 |
797 |
$68K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,554 |
1,028 |
$66K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
851 |
666 |
$63K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
1,862 |
1,453 |
$62K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
849 |
737 |
$61K |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
1,669 |
1,369 |
$56K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,902 |
1,557 |
$53K |
| A4927 |
Gloves, non-sterile, per 100 |
5,599 |
4,125 |
$50K |
| A5120 |
Skin barrier, wipes or swabs, each |
12,627 |
10,064 |
$46K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,218 |
711 |
$45K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
7,459 |
6,150 |
$39K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
1,186 |
750 |
$39K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
870 |
567 |
$39K |
| A4452 |
Tape, waterproof, per 18 square inches |
7,900 |
6,272 |
$34K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
460 |
355 |
$32K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
4,257 |
3,218 |
$32K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
916 |
680 |
$32K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
640 |
377 |
$26K |
| A4371 |
Ostomy skin barrier, powder, per oz |
6,973 |
5,695 |
$25K |
| A4335 |
Incontinence supply; miscellaneous |
2,558 |
1,633 |
$23K |
| A6207 |
Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
552 |
417 |
$21K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
6,686 |
5,084 |
$20K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
514 |
394 |
$20K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
541 |
350 |
$19K |
| A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
645 |
527 |
$18K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,517 |
1,038 |
$14K |
| A4367 |
Ostomy belt, each |
3,752 |
3,157 |
$13K |
| A6545 |
Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each |
710 |
312 |
$13K |
| A6450 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard |
367 |
261 |
$13K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
834 |
507 |
$11K |
| A4373 |
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each |
212 |
144 |
$11K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
700 |
272 |
$11K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
617 |
534 |
$10K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
1,253 |
976 |
$9K |
| A4554 |
Disposable underpads, all sizes |
809 |
363 |
$8K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
659 |
551 |
$8K |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
2,885 |
2,360 |
$7K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
4,198 |
3,462 |
$7K |
| A6452 |
High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard |
80 |
63 |
$7K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,097 |
763 |
$7K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
2,070 |
1,696 |
$7K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
174 |
138 |
$6K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
297 |
188 |
$6K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
1,074 |
795 |
$5K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
167 |
146 |
$5K |
| A4332 |
Lubricant, individual sterile packet, each |
607 |
479 |
$5K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
851 |
622 |
$5K |
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
17 |
12 |
$3K |
| E1399 |
Durable medical equipment, miscellaneous |
500 |
250 |
$3K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
253 |
218 |
$3K |
| A4410 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each |
18 |
14 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
645 |
541 |
$2K |
| A6441 |
Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard |
160 |
114 |
$2K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
33 |
28 |
$2K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
106 |
80 |
$1K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
47 |
22 |
$924.80 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
156 |
128 |
$910.41 |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
12 |
12 |
$757.81 |
| A4322 |
Irrigation syringe, bulb or piston, each |
212 |
159 |
$740.77 |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
136 |
107 |
$695.34 |
| A4396 |
Ostomy belt with peristomal hernia support |
36 |
28 |
$622.57 |
| A9270 |
Non-covered item or service |
1,343 |
473 |
$603.95 |
| A4412 |
Ostomy pouch, drainable, high output, for use on a barrier with flange (2 piece system), without filter, each |
15 |
12 |
$363.96 |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
35 |
25 |
$342.43 |
| A6442 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard |
56 |
37 |
$302.94 |
| A4402 |
Lubricant, per ounce |
72 |
62 |
$296.49 |
| A6445 |
Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard |
15 |
13 |
$221.61 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
44 |
39 |
$208.21 |
| A4405 |
Ostomy skin barrier, non-pectin based, paste, per ounce |
16 |
13 |
$93.48 |
| A6217 |
Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
14 |
12 |
$44.12 |