| 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 |
33,570 |
31,243 |
$14.64M |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
116,881 |
104,811 |
$10.92M |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
27,940 |
23,770 |
$6.41M |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
7,198 |
6,840 |
$5.50M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
70,316 |
63,165 |
$5.48M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
63,566 |
57,401 |
$5.33M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
58,058 |
52,430 |
$5.18M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
92,723 |
83,077 |
$4.90M |
| E0784 |
External ambulatory infusion pump, insulin |
3,934 |
3,089 |
$4.82M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
65,928 |
56,752 |
$4.33M |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
28,314 |
22,444 |
$4.03M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
19,325 |
16,146 |
$3.29M |
| A4927 |
Gloves, non-sterile, per 100 |
259,162 |
220,758 |
$3.20M |
| T4541 |
Incontinence product, disposable underpad, large, each |
148,360 |
133,349 |
$2.89M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
28,374 |
25,213 |
$2.54M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
31,021 |
26,229 |
$2.38M |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
4,650 |
3,825 |
$2.33M |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
2,901 |
2,182 |
$1.87M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
18,159 |
15,911 |
$1.71M |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
26,149 |
22,160 |
$1.65M |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
18,061 |
14,905 |
$1.52M |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
18,885 |
16,523 |
$1.35M |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
2,269 |
2,172 |
$1.31M |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
7,858 |
6,383 |
$1.24M |
| A4259 |
Lancets, per box of 100 |
74,213 |
67,977 |
$1.18M |
| A4215 |
Needle, sterile, any size, each |
35,481 |
32,717 |
$1.10M |
| 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 |
3,119 |
2,517 |
$960K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
56,133 |
49,405 |
$955K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
10,817 |
8,758 |
$910K |
| 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 |
2,386 |
1,974 |
$831K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
13,194 |
11,529 |
$824K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
8,981 |
7,979 |
$824K |
| 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 |
7,957 |
4,817 |
$778K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
7,252 |
5,706 |
$765K |
| 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 |
7,740 |
5,059 |
$752K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,780 |
2,192 |
$664K |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
1,409 |
1,269 |
$631K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
4,776 |
4,075 |
$619K |
| 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 |
5,399 |
3,286 |
$606K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
3,646 |
3,265 |
$597K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
4,503 |
3,628 |
$544K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
2,522 |
2,052 |
$529K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
10,586 |
8,477 |
$486K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
18,028 |
15,772 |
$437K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
9,946 |
9,109 |
$431K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
10,004 |
7,874 |
$374K |
| S8490 |
Insulin syringes (100 syringes, any size) |
9,681 |
8,730 |
$362K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
10,200 |
8,399 |
$349K |
| A4670 |
Automatic blood pressure monitor |
7,278 |
7,062 |
$313K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
4,875 |
3,948 |
$293K |
| 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 |
3,922 |
3,202 |
$283K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
1,770 |
1,589 |
$278K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,708 |
3,321 |
$268K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
4,284 |
3,375 |
$264K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,242 |
1,818 |
$251K |
| B9998 |
Noc for enteral supplies |
5,280 |
3,945 |
$246K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
1,037 |
873 |
$234K |
| 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 |
1,348 |
1,086 |
$226K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
3,524 |
2,817 |
$222K |
| A4456 |
Adhesive remover, wipes, any type, each |
21,614 |
18,078 |
$217K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
3,344 |
2,722 |
$213K |
| 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 |
557 |
384 |
$210K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
2,355 |
1,979 |
$199K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
1,687 |
1,264 |
$193K |
| A4452 |
Tape, waterproof, per 18 square inches |
9,649 |
7,725 |
$185K |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
3,740 |
3,347 |
$184K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
2,276 |
1,788 |
$180K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
1,784 |
1,476 |
$175K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,119 |
1,059 |
$172K |
| A4322 |
Irrigation syringe, bulb or piston, each |
6,375 |
5,050 |
$172K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
4,884 |
3,786 |
$165K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
18,599 |
14,769 |
$145K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
4,835 |
4,031 |
$141K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
1,227 |
1,028 |
$134K |
| A4389 |
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each |
1,991 |
1,416 |
$127K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,290 |
1,048 |
$118K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
2,156 |
1,654 |
$116K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,684 |
1,461 |
$109K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
7,278 |
5,920 |
$105K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
4,437 |
3,304 |
$99K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
2,804 |
1,572 |
$98K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
2,949 |
2,651 |
$97K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
2,492 |
2,003 |
$95K |
| A5120 |
Skin barrier, wipes or swabs, each |
21,513 |
17,566 |
$92K |
| E0607 |
Home blood glucose monitor |
1,870 |
1,732 |
$86K |
| 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 |
1,402 |
1,085 |
$85K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
5,837 |
4,629 |
$83K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
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-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
1,207 |
1,017 |
$67K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
6,954 |
6,015 |
$66K |
| A4373 |
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each |
911 |
727 |
$66K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
1,155 |
895 |
$63K |
| A4416 |
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each |
728 |
598 |
$62K |
| A4390 |
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each |
547 |
438 |
$56K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
9,499 |
7,358 |
$51K |
| 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 |
497 |
275 |
$51K |
| A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
1,458 |
1,193 |
$49K |
| A4332 |
Lubricant, individual sterile packet, each |
4,932 |
4,030 |
$48K |
| A4402 |
Lubricant, per ounce |
8,753 |
7,523 |
$48K |
| A4930 |
Gloves, sterile, per pair |
1,151 |
921 |
$48K |
| A4396 |
Ostomy belt with peristomal hernia support |
1,322 |
1,119 |
$43K |
| B4100 |
Food thickener, administered orally, per ounce |
626 |
424 |
$41K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
615 |
495 |
$41K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
6,143 |
5,096 |
$39K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
435 |
366 |
$38K |
| A4388 |
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each |
467 |
396 |
$37K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
670 |
555 |
$34K |
| A4371 |
Ostomy skin barrier, powder, per oz |
8,258 |
6,885 |
$32K |
| A4256 |
Normal, low and high calibrator solution / chips |
4,055 |
3,710 |
$32K |
| A4367 |
Ostomy belt, each |
6,512 |
5,352 |
$31K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
4,735 |
3,894 |
$25K |
| A4335 |
Incontinence supply; miscellaneous |
4,505 |
4,001 |
$25K |
| A4247 |
Betadine or iodine swabs/wipes, per box |
1,774 |
1,470 |
$23K |
| A4430 |
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each |
392 |
258 |
$20K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
815 |
645 |
$20K |
| A4410 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each |
195 |
154 |
$20K |
| E1399 |
Durable medical equipment, miscellaneous |
339 |
246 |
$20K |
| A4649 |
Surgical supply; miscellaneous |
312 |
285 |
$20K |
| A5054 |
Ostomy pouch, closed; for use on barrier with flange (2 piece), each |
267 |
211 |
$20K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
2,696 |
2,224 |
$18K |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
1,300 |
1,012 |
$15K |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
5,156 |
4,400 |
$14K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
99 |
79 |
$14K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
3,671 |
3,109 |
$13K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
4,773 |
3,025 |
$12K |
| A6545 |
Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each |
304 |
197 |
$11K |
| A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
2,540 |
2,056 |
$10K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
114 |
92 |
$8K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
161 |
142 |
$7K |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
1,885 |
1,439 |
$6K |
| A4428 |
Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each |
41 |
36 |
$5K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
47 |
41 |
$5K |
| A4408 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each |
30 |
25 |
$4K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
196 |
171 |
$4K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
43 |
39 |
$4K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
72 |
68 |
$3K |
| A4411 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each |
65 |
50 |
$3K |
| A4423 |
Ostomy pouch, closed; for use on barrier with locking flange, with filter (2 piece), each |
36 |
25 |
$3K |
| A4258 |
Spring-powered device for lancet, each |
240 |
231 |
$3K |
| A4208 |
Syringe with needle, sterile 3 cc, each |
875 |
841 |
$2K |
| A5112 |
Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each |
105 |
78 |
$2K |
| A6261 |
Wound filler, gel/paste, per fluid ounce, not otherwise specified |
44 |
39 |
$2K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
243 |
201 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
34 |
28 |
$1K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
698 |
448 |
$1K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
57 |
40 |
$1K |
| A9270 |
Non-covered item or service |
1,299 |
949 |
$1K |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
235 |
155 |
$980.01 |
| S8265 |
Haberman feeder for cleft lip/palate |
17 |
13 |
$941.05 |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
16 |
14 |
$792.83 |
| A6260 |
Wound cleansers, any type, any size |
622 |
556 |
$468.07 |
| A4554 |
Disposable underpads, all sizes |
1,461 |
957 |
$458.90 |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
21 |
17 |
$426.23 |
| A4405 |
Ostomy skin barrier, non-pectin based, paste, per ounce |
24 |
21 |
$245.56 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
14 |
12 |
$13.50 |