| 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 |
58,216 |
56,437 |
$20.35M |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
16,800 |
15,962 |
$7.83M |
| 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 |
5,122 |
4,079 |
$4.76M |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
9,149 |
8,819 |
$4.72M |
| E0784 |
External ambulatory infusion pump, insulin |
1,558 |
1,341 |
$4.70M |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
26,638 |
25,173 |
$4.56M |
| 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 |
13,535 |
13,237 |
$2.56M |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
3,753 |
3,568 |
$1.90M |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
22,335 |
20,883 |
$1.68M |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
26,562 |
25,126 |
$1.46M |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
6,421 |
6,140 |
$1.39M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
9,221 |
9,087 |
$1.05M |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
18,756 |
14,349 |
$929K |
| A4554 |
Disposable underpads, all sizes |
19,449 |
18,973 |
$832K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
23,545 |
22,756 |
$674K |
| 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 |
5,117 |
4,840 |
$663K |
| B4149 |
Enteral formula, manufactured blenderized natural foods with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,053 |
1,009 |
$523K |
| E1399 |
Durable medical equipment, miscellaneous |
6,089 |
1,218 |
$478K |
| 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 |
2,352 |
2,180 |
$451K |
| A4245 |
Alcohol wipes, per box |
22,451 |
21,719 |
$437K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
4,727 |
4,645 |
$408K |
| A5120 |
Skin barrier, wipes or swabs, each |
25,142 |
24,494 |
$406K |
| B4153 |
Enteral formula, nutritionally complete, hydrolyzed proteins (amino acids and peptide chain), includes fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
463 |
424 |
$355K |
| A4927 |
Gloves, non-sterile, per 100 |
20,263 |
19,799 |
$319K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,989 |
2,924 |
$275K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,481 |
2,446 |
$261K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
2,654 |
2,611 |
$258K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
3,014 |
2,935 |
$255K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,720 |
2,626 |
$219K |
| B9002 |
Enteral nutrition infusion pump, any type |
3,626 |
3,159 |
$209K |
| A4259 |
Lancets, per box of 100 |
14,212 |
13,214 |
$199K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
1,741 |
1,716 |
$187K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,585 |
1,550 |
$174K |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
8,122 |
7,774 |
$117K |
| B4100 |
Food thickener, administered orally, per ounce |
1,129 |
913 |
$107K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,133 |
1,083 |
$102K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,709 |
1,675 |
$89K |
| A4215 |
Needle, sterile, any size, each |
3,907 |
3,654 |
$84K |
| B4102 |
Enteral formula, for adults, used to replace fluids and electrolytes (e.g., clear liquids), 500 ml = 1 unit |
413 |
296 |
$83K |
| 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 |
513 |
457 |
$76K |
| A9270 |
Non-covered item or service |
3,084 |
2,700 |
$73K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
634 |
624 |
$53K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
574 |
567 |
$43K |
| A4649 |
Surgical supply; miscellaneous |
300 |
247 |
$42K |
| B4155 |
Enteral formula, nutritionally incomplete/modular nutrients, includes specific nutrients, carbohydrates (e.g., glucose polymers), proteins/amino acids (e.g., glutamine, arginine), fat (e.g., medium chain triglycerides) or combination, administered through an enteral feeding tube, 100 calories = 1 unit |
608 |
578 |
$39K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
270 |
269 |
$29K |
| A4456 |
Adhesive remover, wipes, any type, each |
3,359 |
3,260 |
$24K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
2,428 |
2,385 |
$23K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
459 |
428 |
$23K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
599 |
570 |
$19K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,365 |
2,324 |
$17K |
| S8490 |
Insulin syringes (100 syringes, any size) |
723 |
673 |
$16K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
185 |
165 |
$16K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
109 |
108 |
$16K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
349 |
335 |
$16K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,314 |
875 |
$16K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,034 |
707 |
$16K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
111 |
110 |
$11K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,238 |
1,211 |
$10K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
1,773 |
1,710 |
$10K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
425 |
417 |
$9K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
72 |
40 |
$8K |
| A4371 |
Ostomy skin barrier, powder, per oz |
506 |
483 |
$7K |
| B9998 |
Noc for enteral supplies |
15 |
14 |
$6K |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
374 |
365 |
$5K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
198 |
182 |
$4K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
43 |
39 |
$4K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
357 |
332 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
234 |
229 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
469 |
433 |
$3K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
181 |
175 |
$3K |
| E0776 |
Iv pole |
313 |
303 |
$2K |
| E0570 |
Nebulizer, with compressor |
40 |
38 |
$2K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
30 |
25 |
$2K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
17 |
16 |
$2K |
| T4541 |
Incontinence product, disposable underpad, large, each |
52 |
52 |
$2K |
| T4540 |
Incontinence product, protective underpad, reusable, chair size, each |
225 |
224 |
$2K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
12 |
12 |
$2K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
40 |
38 |
$2K |
| A7002 |
Tubing, used with suction pump, each |
289 |
278 |
$672.21 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
84 |
81 |
$486.72 |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
146 |
135 |
$470.42 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
27 |
25 |
$423.40 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
34 |
31 |
$388.82 |
| A4256 |
Normal, low and high calibrator solution / chips |
64 |
62 |
$387.94 |
| A4402 |
Lubricant, per ounce |
59 |
51 |
$294.25 |
| A4258 |
Spring-powered device for lancet, each |
14 |
13 |
$165.67 |
| A4367 |
Ostomy belt, each |
25 |
24 |
$119.89 |