| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
5,793 |
5,758 |
$1.83M |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
3,765 |
3,697 |
$1.03M |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
7,357 |
7,325 |
$576K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
2,347 |
1,969 |
$391K |
| A4231 |
Infusion set for external insulin pump, needle type |
1,564 |
1,558 |
$211K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
2,370 |
1,988 |
$173K |
| 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 |
990 |
796 |
$165K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
1,115 |
893 |
$156K |
| A4238 |
Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
587 |
587 |
$153K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,019 |
828 |
$134K |
| 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 |
2,590 |
2,161 |
$124K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
3,905 |
3,411 |
$66K |
| A4452 |
Tape, waterproof, per 18 square inches |
3,759 |
3,179 |
$62K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
153 |
151 |
$32K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
748 |
695 |
$27K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
870 |
658 |
$27K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
358 |
299 |
$26K |
| 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 |
122 |
108 |
$23K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
5,665 |
4,741 |
$20K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
361 |
282 |
$18K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
205 |
197 |
$17K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
749 |
629 |
$14K |
| 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 |
71 |
50 |
$11K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
168 |
133 |
$11K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
2,759 |
2,374 |
$9K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
307 |
238 |
$8K |
| A4259 |
Lancets, per box of 100 |
465 |
430 |
$6K |
| 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 |
187 |
151 |
$5K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
29 |
26 |
$4K |
| A4927 |
Gloves, non-sterile, per 100 |
577 |
464 |
$3K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
115 |
87 |
$3K |
| A5120 |
Skin barrier, wipes or swabs, each |
353 |
281 |
$2K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
294 |
262 |
$1K |
| A6260 |
Wound cleansers, any type, any size |
511 |
452 |
$981.11 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
46 |
40 |
$233.54 |
| A6445 |
Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard |
18 |
12 |
$66.04 |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
44 |
39 |
$0.00 |