| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
33,570 |
31,243 |
$14.64M |
| A4253 |
Blood glucose/reagent strips |
116,881 |
104,811 |
$10.92M |
| A4239 |
Non-adju cgm supply allow |
27,940 |
23,770 |
$6.41M |
| A9277 |
External transmitter, cgm |
7,198 |
6,840 |
$5.50M |
| T4526 |
Adult size pull-on med |
70,316 |
63,165 |
$5.48M |
| T4527 |
Adult size pull-on lg |
63,566 |
57,401 |
$5.33M |
| T4528 |
Adult size pull-on xl |
58,058 |
52,430 |
$5.18M |
| T4535 |
Disposable liner/shield/pad |
92,723 |
83,077 |
$4.90M |
| E0784 |
Ext amb infusn pump insulin |
3,934 |
3,089 |
$4.82M |
| T4534 |
Youth size pull-on |
65,928 |
56,752 |
$4.33M |
| K0553 |
Ther cgm supply allowance |
28,314 |
22,444 |
$4.03M |
| A4351 |
Straight tip urine catheter |
19,325 |
16,146 |
$3.29M |
| A4927 |
Non-sterile gloves |
259,162 |
220,758 |
$3.20M |
| T4541 |
Large disposable underpad |
148,360 |
133,349 |
$2.89M |
| T4523 |
Adult size brief/diaper lg |
28,374 |
25,213 |
$2.54M |
| T4522 |
Adult size brief/diaper med |
31,021 |
26,229 |
$2.38M |
| A4352 |
Coude tip urinary catheter |
4,650 |
3,825 |
$2.33M |
| A4353 |
Intermittent urinary cath |
2,901 |
2,182 |
$1.87M |
| T4524 |
Adult size brief/diaper xl |
18,159 |
15,911 |
$1.71M |
| T4530 |
Ped size brief/diaper lg |
26,149 |
22,160 |
$1.65M |
| A4385 |
Ost skn barrier sld ext wear |
18,061 |
14,905 |
$1.52M |
| A4224 |
Supply insulin inf cath/wk |
18,885 |
16,523 |
$1.35M |
| A9278 |
External receiver, cgm sys |
2,269 |
2,172 |
$1.31M |
| A6212 |
Foam drg <=16 sq in w/border |
7,858 |
6,383 |
$1.24M |
| A4259 |
Lancets per box |
74,213 |
67,977 |
$1.18M |
| A4215 |
Sterile needle |
35,481 |
32,717 |
$1.10M |
| A6197 |
Alginate drsg >16 <=48 sq in |
3,119 |
2,517 |
$960K |
| T4537 |
Reusable underpad bed size |
56,133 |
49,405 |
$955K |
| A4409 |
Ost skn barr convex <=4 sq i |
10,817 |
8,758 |
$910K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
2,386 |
1,974 |
$831K |
| T4525 |
Adult size pull-on sm |
13,194 |
11,529 |
$824K |
| A4221 |
Supp non-insulin inf cath/wk |
8,981 |
7,979 |
$824K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
7,957 |
4,817 |
$778K |
| A4407 |
Ext wear ost skn barr <=4sq" |
7,252 |
5,706 |
$765K |
| B4150 |
Ef complet w/intact nutrient |
7,740 |
5,059 |
$752K |
| B4035 |
Enteral feed supp pump per d |
2,780 |
2,192 |
$664K |
| A9274 |
Ext amb insulin delivery sys |
1,409 |
1,269 |
$631K |
| T4543 |
Adult disp brief/diap abv xl |
4,776 |
4,075 |
$619K |
| B4152 |
Ef calorie dense>/=1.5kcal |
5,399 |
3,286 |
$606K |
| A4230 |
Infus insulin pump non needl |
3,646 |
3,265 |
$597K |
| A5057 |
1 pc ost pou w built-in conv |
4,503 |
3,628 |
$544K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
2,522 |
2,052 |
$529K |
| A4425 |
Ost pch drain for barrier fl |
10,586 |
8,477 |
$486K |
| A4225 |
Sup/ext insulin inf pump syr |
18,028 |
15,772 |
$437K |
| A4232 |
Syringe w/needle insulin 3cc |
9,946 |
9,109 |
$431K |
| A4362 |
Solid skin barrier |
10,004 |
7,874 |
$374K |
| S8490 |
100 insulin syringes |
9,681 |
8,730 |
$362K |
| A4394 |
Ostomy pouch liq deodorant |
10,200 |
8,399 |
$349K |
| A4670 |
Automatic bp monitor, dial |
7,278 |
7,062 |
$313K |
| A4419 |
Ost pch for bar w flange/flt |
4,875 |
3,948 |
$293K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
3,922 |
3,202 |
$283K |
| E2103 |
Non-adju cgm receiver/mon |
1,770 |
1,589 |
$278K |
| T4532 |
Ped size pull-on lg |
3,708 |
3,321 |
$268K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
4,284 |
3,375 |
$264K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
2,242 |
1,818 |
$251K |
| B9998 |
Enteral supp not otherwise c |
5,280 |
3,945 |
$246K |
| A6021 |
Collagen dressing <=16 sq in |
1,037 |
873 |
$234K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
1,348 |
1,086 |
$226K |
| A5056 |
1 pc ost pouch w filter |
3,524 |
2,817 |
$222K |
| A4456 |
Adhesive remover, wipes |
21,614 |
18,078 |
$217K |
| T4521 |
Adult size brief/diaper sm |
3,344 |
2,722 |
$213K |
| B4161 |
Ef ped hydrolyzed/amino acid |
557 |
384 |
$210K |
| A4424 |
Ost pch drain w bar & filter |
2,355 |
1,979 |
$199K |
| K0554 |
Ther cgm receiver/monitor |
1,687 |
1,264 |
$193K |
| A4452 |
Waterproof tape |
9,649 |
7,725 |
$185K |
| A4206 |
1 cc sterile syringe&needle |
3,740 |
3,347 |
$184K |
| A5121 |
Solid skin barrier 6x6 |
2,276 |
1,788 |
$180K |
| A6258 |
Transparent film >16<=48 in |
1,784 |
1,476 |
$175K |
| E0603 |
Electric breast pump |
1,119 |
1,059 |
$172K |
| A4322 |
Irrigation syringe |
6,375 |
5,050 |
$172K |
| A5063 |
Drain ostomy pouch w/flange |
4,884 |
3,786 |
$165K |
| A4357 |
Bedside drainage bag |
18,599 |
14,769 |
$145K |
| A6446 |
Conform band s w>=3" <5"/yd |
4,835 |
4,031 |
$141K |
| A6196 |
Alginate dressing <=16 sq in |
1,227 |
1,028 |
$134K |
| A4389 |
Drainable pch w st wear barr |
1,991 |
1,416 |
$127K |
| B4034 |
Enter feed supkit syr by day |
1,290 |
1,048 |
$118K |
| B4088 |
Gastro/jejuno tube, low-pro |
2,156 |
1,654 |
$116K |
| B4036 |
Enteral feed sup kit grav by |
1,684 |
1,461 |
$109K |
| A4406 |
Pectin based ostomy paste |
7,278 |
5,920 |
$105K |
| A4349 |
Disposable male external cat |
4,437 |
3,304 |
$99K |
| A4344 |
Cath indw foley 2 way silicn |
2,804 |
1,572 |
$98K |
| K0552 |
Sup/ext non-ins inf pump syr |
2,949 |
2,651 |
$97K |
| A4432 |
Os pch urine w bar/fange/tap |
2,492 |
2,003 |
$95K |
| A5120 |
Skin barrier, wipe or swab |
21,513 |
17,566 |
$92K |
| E0607 |
Blood glucose monitor home |
1,870 |
1,732 |
$86K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
1,402 |
1,085 |
$85K |
| A4338 |
Indwelling catheter latex |
5,837 |
4,629 |
$83K |
| A4310 |
Insert tray w/o bag/cath |
7,469 |
5,785 |
$81K |
| A4245 |
Alcohol wipes per box |
15,863 |
14,640 |
$78K |
| A4217 |
Sterile water/saline, 500 ml |
4,467 |
3,606 |
$71K |
| A6454 |
Self-adher band w>=3" <5"/yd |
1,207 |
1,017 |
$67K |
| A6402 |
Sterile gauze <= 16 sq in |
6,954 |
6,015 |
$66K |
| A4373 |
Skin barrier with flange |
911 |
727 |
$66K |
| A6257 |
Transparent film <= 16 sq in |
1,155 |
895 |
$63K |
| A4416 |
Ost pch clsd w barrier/filtr |
728 |
598 |
$62K |
| A4390 |
Drainable pch ex wear convex |
547 |
438 |
$56K |
| A4358 |
Urinary leg or abdomen bag |
9,499 |
7,358 |
$51K |
| B4154 |
Ef spec metabolic noninherit |
497 |
275 |
$51K |
| A4427 |
Ost pch drain/barr lk flng/f |
1,458 |
1,193 |
$49K |
| A4332 |
Lube sterile packet |
4,932 |
4,030 |
$48K |
| A4402 |
Lubricant per ounce |
8,753 |
7,523 |
$48K |
| A4930 |
Sterile, gloves per pair |
1,151 |
921 |
$48K |
| A4396 |
Peristomal hernia supprt blt |
1,322 |
1,119 |
$43K |
| B4100 |
Food thickener oral |
626 |
424 |
$41K |
| A5061 |
Pouch drainable w barrier at |
615 |
495 |
$41K |
| A6216 |
Non-sterile gauze<=16 sq in |
6,143 |
5,096 |
$39K |
| A6449 |
Lt compres band >=3" <5"/yd |
435 |
366 |
$38K |
| A4388 |
Drainable pch w ex wear barr |
467 |
396 |
$37K |
| T4533 |
Youth size brief/diaper |
670 |
555 |
$34K |
| A4371 |
Skin barrier powder per oz |
8,258 |
6,885 |
$32K |
| A4256 |
Calibrator solution/chips |
4,055 |
3,710 |
$32K |
| A4367 |
Ostomy belt |
6,512 |
5,352 |
$31K |
| A4450 |
Non-waterproof tape |
4,735 |
3,894 |
$25K |
| A4335 |
Incontinence supply |
4,505 |
4,001 |
$25K |
| A4247 |
Betadine/iodine swabs/wipes |
1,774 |
1,470 |
$23K |
| A4430 |
Ost urine pch w b/bltin conv |
392 |
258 |
$20K |
| A6457 |
Tubular dressing |
815 |
645 |
$20K |
| A4410 |
Ost skn barr extnd >4 sq |
195 |
154 |
$20K |
| E1399 |
Durable medical equipment mi |
339 |
246 |
$20K |
| A4649 |
Surgical supplies |
312 |
285 |
$20K |
| A5054 |
Clsd ostomy pouch w/flange |
267 |
211 |
$20K |
| A4333 |
Urinary cath anchor device |
2,696 |
2,224 |
$18K |
| A4320 |
Irrigation tray |
1,300 |
1,012 |
$15K |
| A4369 |
Skin barrier liquid per oz |
5,156 |
4,400 |
$14K |
| A6199 |
Alginate drsg wound filler |
99 |
79 |
$14K |
| A4455 |
Adhesive remover per ounce |
3,671 |
3,109 |
$13K |
| A4520 |
Incontinence garment anytype |
4,773 |
3,025 |
$12K |
| A6545 |
Grad com non-elastic bk surg |
304 |
197 |
$11K |
| A4331 |
Extension drainage tubing |
2,540 |
2,056 |
$10K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
114 |
92 |
$8K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
161 |
142 |
$7K |
| A4334 |
Urinary cath leg strap |
1,885 |
1,439 |
$6K |
| A4428 |
Urine ost pouch w faucet/tap |
41 |
36 |
$5K |
| A6266 |
Impreg gauze no h20/sal/yard |
47 |
41 |
$5K |
| A4408 |
Ext wear ost skn barr >4sq" |
30 |
25 |
$4K |
| A6219 |
Gauze <= 16 sq in w/border |
196 |
171 |
$4K |
| T4531 |
Ped size pull-on sm/med |
43 |
39 |
$4K |
| A6248 |
Hydrogel drsg gel filler |
72 |
68 |
$3K |
| A4411 |
Ost skn barr extnd =4sq |
65 |
50 |
$3K |
| A4423 |
Ost pch for bar w lk fl/fltr |
36 |
25 |
$3K |
| A4258 |
Lancet device each |
240 |
231 |
$3K |
| A4208 |
3 cc sterile syringe&needle |
875 |
841 |
$2K |
| A5112 |
Urinary leg bag |
105 |
78 |
$2K |
| A6261 |
Wound filler gel/paste /oz |
44 |
39 |
$2K |
| A4364 |
Adhesive, liquid or equal |
243 |
201 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
34 |
28 |
$1K |
| A4314 |
Cath w/drainage 2-way latex |
698 |
448 |
$1K |
| T4536 |
Reusable pull-on any size |
57 |
40 |
$1K |
| A9270 |
Non-covered item or service |
1,299 |
949 |
$1K |
| A5131 |
Appliance cleaner |
235 |
155 |
$980.01 |
| S8265 |
Haberman feeder |
17 |
13 |
$941.05 |
| A6251 |
Absorpt drg <=16 sq in w/o b |
16 |
14 |
$792.83 |
| A6260 |
Wound cleanser any type/size |
622 |
556 |
$468.07 |
| A4554 |
Disposable underpads |
1,461 |
957 |
$458.90 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
21 |
17 |
$426.23 |
| A4405 |
Nonpectin based ostomy paste |
24 |
21 |
$245.56 |
| A6250 |
Skin seal protect moisturizr |
14 |
12 |
$13.50 |