| 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 |
54,922 |
49,427 |
$16.26M |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
72,894 |
63,652 |
$11.48M |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
41,849 |
38,392 |
$6.53M |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
10,024 |
9,240 |
$5.28M |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
28,066 |
25,406 |
$4.75M |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
6,585 |
5,489 |
$4.03M |
| E0784 |
External ambulatory infusion pump, insulin |
1,325 |
1,006 |
$3.37M |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
3,322 |
2,899 |
$1.18M |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
5,692 |
4,573 |
$790K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
4,522 |
3,953 |
$616K |
| A4554 |
Disposable underpads, all sizes |
10,334 |
9,661 |
$577K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
11,450 |
10,723 |
$552K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
15,670 |
13,512 |
$431K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
3,909 |
3,656 |
$413K |
| A7048 |
Vacuum drainage collection unit and tubing kit, including all supplies needed for collection unit change, for use with implanted catheter, each |
1,793 |
609 |
$392K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,672 |
4,422 |
$379K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
2,440 |
2,254 |
$301K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
2,396 |
2,275 |
$263K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
6,728 |
5,752 |
$239K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,541 |
1,454 |
$224K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
1,725 |
1,497 |
$206K |
| A4231 |
Infusion set for external insulin pump, needle type |
1,587 |
1,341 |
$179K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
3,967 |
3,608 |
$125K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
4,275 |
3,692 |
$86K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,749 |
2,471 |
$81K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,371 |
1,199 |
$60K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
918 |
860 |
$57K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
760 |
728 |
$54K |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
1,339 |
862 |
$49K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
850 |
672 |
$46K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
809 |
710 |
$40K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
838 |
727 |
$38K |
| A4927 |
Gloves, non-sterile, per 100 |
9,000 |
8,102 |
$37K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
467 |
433 |
$35K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
1,009 |
703 |
$27K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
606 |
534 |
$26K |
| 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 |
576 |
525 |
$26K |
| A4456 |
Adhesive remover, wipes, any type, each |
2,905 |
2,457 |
$23K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
277 |
229 |
$22K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
548 |
441 |
$22K |
| A5120 |
Skin barrier, wipes or swabs, each |
2,779 |
2,418 |
$22K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,135 |
1,980 |
$21K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
2,040 |
1,691 |
$20K |
| A4238 |
Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
57 |
52 |
$18K |
| 99503 |
|
105 |
94 |
$18K |
| A4259 |
Lancets, per box of 100 |
3,086 |
2,699 |
$16K |
| A4670 |
Automatic blood pressure monitor |
201 |
183 |
$10K |
| E0607 |
Home blood glucose monitor |
367 |
328 |
$9K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,104 |
941 |
$8K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
832 |
721 |
$7K |
| A4402 |
Lubricant, per ounce |
1,819 |
1,662 |
$6K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,186 |
1,091 |
$6K |
| A4245 |
Alcohol wipes, per box |
2,180 |
1,910 |
$5K |
| A4217 |
Sterile water/saline, 500 ml |
716 |
639 |
$5K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
429 |
384 |
$5K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
345 |
281 |
$5K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
18 |
14 |
$4K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
51 |
36 |
$4K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
68 |
64 |
$3K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
204 |
142 |
$3K |
| 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 |
28 |
24 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
429 |
367 |
$3K |
| 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 |
19 |
13 |
$3K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
79 |
51 |
$2K |
| A4371 |
Ostomy skin barrier, powder, per oz |
183 |
150 |
$2K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
159 |
137 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
486 |
438 |
$2K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
33 |
27 |
$1K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
67 |
50 |
$1K |
| T4541 |
Incontinence product, disposable underpad, large, each |
31 |
24 |
$1K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
43 |
40 |
$982.18 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
67 |
42 |
$215.88 |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
12 |
12 |
$195.71 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
44 |
29 |
$194.26 |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
12 |
12 |
$66.27 |
| A4258 |
Spring-powered device for lancet, each |
16 |
16 |
$64.62 |
| 99080 |
|
2,129 |
1,608 |
$0.00 |