| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
3,352 |
3,114 |
$2.29M |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
6,649 |
6,440 |
$2.18M |
| 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 |
9,564 |
8,917 |
$2.09M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
7,455 |
7,045 |
$1.13M |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
18,101 |
17,620 |
$1.01M |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
1,503 |
1,403 |
$872K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
11,430 |
10,661 |
$842K |
| 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 |
9,497 |
9,023 |
$724K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
3,514 |
3,312 |
$715K |
| E0784 |
External ambulatory infusion pump, insulin |
2,128 |
1,926 |
$686K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
8,528 |
8,333 |
$570K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
7,515 |
7,281 |
$567K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
9,588 |
9,484 |
$527K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
11,903 |
11,673 |
$420K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
4,896 |
4,485 |
$419K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
2,209 |
2,066 |
$403K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
3,286 |
3,043 |
$401K |
| 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 |
2,721 |
2,604 |
$394K |
| E1399 |
Durable medical equipment, miscellaneous |
4,072 |
2,046 |
$374K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
8,670 |
8,358 |
$331K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
10,866 |
10,373 |
$318K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
6,407 |
6,228 |
$316K |
| A4927 |
Gloves, non-sterile, per 100 |
17,538 |
16,822 |
$283K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
3,922 |
3,821 |
$269K |
| T4541 |
Incontinence product, disposable underpad, large, each |
8,049 |
7,875 |
$245K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
2,412 |
2,295 |
$236K |
| 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 |
2,662 |
2,443 |
$235K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
6,716 |
6,436 |
$226K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
9,675 |
9,494 |
$209K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,218 |
2,160 |
$195K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,576 |
2,490 |
$191K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,386 |
4,258 |
$189K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
3,004 |
2,879 |
$186K |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
435 |
424 |
$185K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
5,804 |
5,648 |
$173K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,289 |
2,242 |
$167K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,747 |
2,624 |
$167K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
2,675 |
2,638 |
$164K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
1,293 |
1,246 |
$156K |
| A4456 |
Adhesive remover, wipes, any type, each |
17,437 |
16,742 |
$156K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
2,732 |
2,583 |
$156K |
| A5120 |
Skin barrier, wipes or swabs, each |
24,742 |
20,430 |
$154K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
3,528 |
3,427 |
$153K |
| A4389 |
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each |
2,226 |
2,135 |
$143K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
15,795 |
12,953 |
$137K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
16,968 |
16,260 |
$131K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,262 |
2,049 |
$130K |
| 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 |
3,666 |
3,513 |
$128K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
3,987 |
3,901 |
$125K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
25,384 |
20,550 |
$123K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
2,051 |
1,998 |
$122K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,005 |
2,849 |
$115K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
2,618 |
2,497 |
$103K |
| A4452 |
Tape, waterproof, per 18 square inches |
13,595 |
12,393 |
$103K |
| A4390 |
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each |
996 |
945 |
$98K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
2,257 |
2,194 |
$98K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
787 |
779 |
$90K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,064 |
1,046 |
$90K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
4,861 |
4,670 |
$88K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
7,180 |
7,036 |
$84K |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
146 |
141 |
$81K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
829 |
806 |
$80K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
13,142 |
12,701 |
$64K |
| A4388 |
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each |
987 |
951 |
$62K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
2,094 |
1,962 |
$61K |
| A4416 |
Ostomy pouch, closed, with barrier attached, with filter (1 piece), each |
789 |
762 |
$60K |
| A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
1,843 |
1,795 |
$58K |
| A6260 |
Wound cleansers, any type, any size |
2,929 |
2,862 |
$55K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
1,149 |
1,105 |
$54K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
1,222 |
1,178 |
$47K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
8,804 |
5,706 |
$46K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
1,201 |
1,160 |
$44K |
| A6456 |
Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
738 |
682 |
$43K |
| A4217 |
Sterile water/saline, 500 ml |
5,364 |
5,146 |
$41K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
2,304 |
2,209 |
$39K |
| 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 |
409 |
391 |
$38K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
889 |
859 |
$38K |
| A4371 |
Ostomy skin barrier, powder, per oz |
9,567 |
9,411 |
$37K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
4,120 |
3,112 |
$37K |
| A4410 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each |
282 |
262 |
$35K |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
2,762 |
2,645 |
$31K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
3,271 |
3,148 |
$30K |
| A4430 |
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each |
381 |
358 |
$30K |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
106 |
106 |
$30K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
1,459 |
1,423 |
$29K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
257 |
255 |
$28K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
2,410 |
2,270 |
$26K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
2,716 |
2,514 |
$26K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
254 |
244 |
$26K |
| A4373 |
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each |
525 |
503 |
$25K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,575 |
1,194 |
$23K |
| A4402 |
Lubricant, per ounce |
3,149 |
3,034 |
$22K |
| A4367 |
Ostomy belt, each |
4,881 |
4,800 |
$17K |
| A4332 |
Lubricant, individual sterile packet, each |
2,040 |
1,847 |
$17K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,044 |
1,014 |
$17K |
| A6450 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard |
395 |
374 |
$14K |
| A4322 |
Irrigation syringe, bulb or piston, each |
1,930 |
1,872 |
$14K |
| A4396 |
Ostomy belt with peristomal hernia support |
750 |
723 |
$13K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
594 |
517 |
$13K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
2,808 |
2,664 |
$12K |
| A6220 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
198 |
191 |
$12K |
| A5200 |
Percutaneous catheter/tube anchoring device, adhesive skin attachment |
220 |
214 |
$12K |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
4,242 |
4,155 |
$12K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
227 |
222 |
$11K |
| A4393 |
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity (1 piece), each |
115 |
107 |
$11K |
| 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 |
2,026 |
1,966 |
$11K |
| A4247 |
Betadine or iodine swabs/wipes, per box |
1,239 |
1,211 |
$9K |
| A6022 |
Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each |
42 |
40 |
$8K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
2,569 |
2,489 |
$8K |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
1,152 |
1,118 |
$8K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
129 |
123 |
$7K |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
1,020 |
999 |
$7K |
| A4245 |
Alcohol wipes, per box |
1,428 |
1,391 |
$6K |
| A4670 |
Automatic blood pressure monitor |
87 |
84 |
$5K |
| A4335 |
Incontinence supply; miscellaneous |
243 |
218 |
$5K |
| A6441 |
Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard |
557 |
526 |
$4K |
| A5054 |
Ostomy pouch, closed; for use on barrier with flange (2 piece), each |
80 |
79 |
$4K |
| A6207 |
Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
154 |
142 |
$4K |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
109 |
106 |
$3K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
1,385 |
1,350 |
$3K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
359 |
350 |
$3K |
| A4259 |
Lancets, per box of 100 |
922 |
891 |
$3K |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
1,288 |
1,231 |
$3K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
640 |
632 |
$2K |
| 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 |
45 |
39 |
$2K |
| B9998 |
Noc for enteral supplies |
15 |
12 |
$2K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
17 |
13 |
$2K |
| A6211 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
12 |
12 |
$2K |
| A4411 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, with built-in convexity, each |
26 |
25 |
$1K |
| A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
434 |
380 |
$1K |
| A4405 |
Ostomy skin barrier, non-pectin based, paste, per ounce |
141 |
138 |
$1K |
| A4930 |
Gloves, sterile, per pair |
54 |
50 |
$1K |
| A4649 |
Surgical supply; miscellaneous |
42 |
42 |
$923.80 |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
41 |
39 |
$439.09 |
| A6218 |
Gauze, non-impregnated, non-sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
28 |
27 |
$432.38 |
| A6442 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width less than three inches, per yard |
41 |
40 |
$369.99 |
| A6203 |
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
12 |
12 |
$340.78 |
| A6407 |
Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard |
12 |
12 |
$285.60 |
| A5112 |
Urinary drainage bag, leg or abdomen, latex, with or without tube, with straps, each |
14 |
12 |
$117.32 |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
14 |
14 |
$106.21 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
84 |
44 |
$0.00 |