| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Gloves, non-sterile, per 100 |
1,787,194 |
1,714,710 |
$26.39M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
344,106 |
323,456 |
$24.77M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
380,823 |
357,645 |
$22.85M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
344,188 |
322,425 |
$21.66M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
759,118 |
714,275 |
$21.38M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
271,081 |
252,749 |
$19.98M |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,125,867 |
1,065,811 |
$19.00M |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
65,681 |
48,322 |
$16.79M |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
185,705 |
175,751 |
$12.40M |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
48,468 |
44,635 |
$11.70M |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
194,720 |
184,879 |
$11.30M |
| E0784 |
External ambulatory infusion pump, insulin |
2,939 |
2,828 |
$10.02M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
145,353 |
137,754 |
$9.76M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
93,774 |
84,591 |
$9.47M |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
97,120 |
90,182 |
$8.78M |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
77,746 |
69,657 |
$8.52M |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
32,191 |
29,506 |
$8.20M |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
118,212 |
111,425 |
$7.40M |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
96,961 |
91,775 |
$5.94M |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
66,289 |
62,788 |
$5.77M |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
149,421 |
134,047 |
$5.50M |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
12,329 |
10,430 |
$5.14M |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
213,829 |
197,992 |
$4.97M |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
32,911 |
30,928 |
$4.73M |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
10,003 |
9,045 |
$4.24M |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
15,275 |
13,686 |
$3.88M |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
6,674 |
5,989 |
$3.20M |
| S5199 |
Personal care item, nos, each |
427,130 |
422,265 |
$3.04M |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
77,442 |
68,923 |
$2.23M |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
26,305 |
24,839 |
$1.58M |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
11,637 |
11,470 |
$1.46M |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
17,800 |
16,984 |
$1.27M |
| 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 |
9,869 |
8,217 |
$1.26M |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
14,523 |
13,787 |
$1.04M |
| 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 |
9,818 |
8,281 |
$860K |
| A4554 |
Disposable underpads, all sizes |
21,551 |
17,806 |
$732K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
201,642 |
193,691 |
$717K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
24,686 |
23,090 |
$578K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
11,837 |
10,291 |
$484K |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
1,246 |
1,084 |
$483K |
| A4259 |
Lancets, per box of 100 |
123,088 |
104,561 |
$445K |
| 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 |
3,485 |
2,931 |
$443K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
1,972 |
1,831 |
$432K |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
10,398 |
5,950 |
$411K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
8,803 |
7,967 |
$378K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
6,934 |
6,185 |
$365K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
4,584 |
4,027 |
$284K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
7,663 |
6,896 |
$277K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
11,259 |
9,943 |
$271K |
| 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 |
1,858 |
1,447 |
$262K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
6,972 |
6,417 |
$248K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
3,559 |
3,319 |
$241K |
| A4231 |
Infusion set for external insulin pump, needle type |
4,014 |
3,353 |
$219K |
| A4256 |
Normal, low and high calibrator solution / chips |
49,671 |
42,189 |
$215K |
| A4670 |
Automatic blood pressure monitor |
3,558 |
3,120 |
$210K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
6,056 |
4,560 |
$206K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
33,717 |
28,913 |
$206K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
8,340 |
7,446 |
$197K |
| A4402 |
Lubricant, per ounce |
77,687 |
72,340 |
$193K |
| A4456 |
Adhesive remover, wipes, any type, each |
11,463 |
10,449 |
$191K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
2,974 |
2,407 |
$179K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
13,354 |
10,762 |
$172K |
| A4335 |
Incontinence supply; miscellaneous |
10,212 |
7,136 |
$172K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
20,524 |
18,097 |
$172K |
| A5120 |
Skin barrier, wipes or swabs, each |
23,722 |
21,692 |
$163K |
| A4238 |
Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
829 |
818 |
$156K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
13,563 |
12,132 |
$149K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
742 |
690 |
$141K |
| T5999 |
Supply, not otherwise specified |
16,726 |
15,755 |
$137K |
| A4388 |
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each |
1,920 |
1,740 |
$109K |
| B4088 |
Gastrostomy/jejunostomy tube, low-profile, any material, any type, each |
1,685 |
1,280 |
$107K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
8,646 |
8,048 |
$107K |
| A4215 |
Needle, sterile, any size, each |
4,701 |
3,816 |
$107K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
1,714 |
1,462 |
$105K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
3,214 |
2,852 |
$94K |
| A4452 |
Tape, waterproof, per 18 square inches |
11,027 |
9,976 |
$91K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
4,128 |
4,034 |
$83K |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
3,542 |
1,895 |
$82K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
1,319 |
1,255 |
$77K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
1,403 |
1,303 |
$70K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
8,511 |
7,782 |
$68K |
| A4389 |
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each |
812 |
711 |
$67K |
| T4542 |
Incontinence product, disposable underpad, small size, each |
6,136 |
5,718 |
$65K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
1,971 |
1,786 |
$58K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
8,233 |
6,949 |
$58K |
| A4322 |
Irrigation syringe, bulb or piston, each |
9,665 |
8,921 |
$56K |
| E0607 |
Home blood glucose monitor |
732 |
651 |
$51K |
| T4536 |
Incontinence product, protective underwear/pull-on, reusable, any size, each |
7,009 |
6,604 |
$47K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
313 |
276 |
$46K |
| A4398 |
Ostomy irrigation supply; bag, each |
4,654 |
4,434 |
$45K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
4,562 |
4,142 |
$45K |
| A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
13,444 |
11,425 |
$45K |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
4,625 |
4,202 |
$36K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
1,026 |
902 |
$36K |
| A4315 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone |
1,280 |
1,106 |
$36K |
| A4399 |
Ostomy irrigation supply; cone/catheter, with or without brush |
4,362 |
4,152 |
$32K |
| E1639 |
Scale, each |
1,248 |
893 |
$32K |
| A4247 |
Betadine or iodine swabs/wipes, per box |
2,300 |
2,024 |
$29K |
| A4649 |
Surgical supply; miscellaneous |
158 |
158 |
$27K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
4,796 |
4,328 |
$27K |
| A4371 |
Ostomy skin barrier, powder, per oz |
10,893 |
10,096 |
$26K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
439 |
352 |
$26K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
627 |
514 |
$24K |
| T4539 |
Incontinence product, diaper/brief, reusable, any size, each |
1,256 |
1,124 |
$24K |
| A4245 |
Alcohol wipes, per box |
12,647 |
9,089 |
$24K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
625 |
552 |
$24K |
| 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 |
246 |
222 |
$23K |
| A4367 |
Ostomy belt, each |
5,834 |
5,380 |
$23K |
| A4332 |
Lubricant, individual sterile packet, each |
3,699 |
3,082 |
$21K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
482 |
434 |
$20K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
100 |
90 |
$19K |
| 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 |
45 |
40 |
$17K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
3,169 |
2,862 |
$17K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
3,998 |
3,593 |
$17K |
| A4340 |
Indwelling catheter; specialty type, (e.g., coude, mushroom, wing, etc.), each |
358 |
305 |
$13K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
2,053 |
1,921 |
$13K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
1,796 |
1,635 |
$13K |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
989 |
974 |
$12K |
| B4087 |
Gastrostomy/jejunostomy tube, standard, any material, any type, each |
355 |
336 |
$10K |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
6,050 |
5,287 |
$10K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
1,143 |
1,026 |
$9K |
| T2028 |
Specialized supply, not otherwise specified, waiver |
267 |
258 |
$8K |
| A4390 |
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each |
140 |
116 |
$7K |
| E0602 |
Breast pump, manual, any type |
103 |
103 |
$5K |
| A4373 |
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each |
80 |
76 |
$5K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
75 |
72 |
$4K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
337 |
327 |
$4K |
| A4217 |
Sterile water/saline, 500 ml |
218 |
194 |
$4K |
| A6260 |
Wound cleansers, any type, any size |
263 |
254 |
$3K |
| A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
163 |
132 |
$3K |
| K0603 |
Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each |
3,803 |
3,731 |
$2K |
| A4663 |
Blood pressure cuff only |
653 |
631 |
$2K |
| A9270 |
Non-covered item or service |
3,774 |
3,730 |
$2K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
16 |
14 |
$1K |
| A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
62 |
54 |
$1K |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
13 |
12 |
$1K |
| A4614 |
Peak expiratory flow rate meter, hand held |
82 |
77 |
$754.43 |
| A5054 |
Ostomy pouch, closed; for use on barrier with flange (2 piece), each |
13 |
13 |
$628.55 |
| B4100 |
Food thickener, administered orally, per ounce |
15 |
13 |
$539.51 |
| A4258 |
Spring-powered device for lancet, each |
63 |
36 |
$148.07 |
| A4233 |
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each |
16 |
16 |
$0.00 |
| A4559 |
Coupling gel or paste, for use with ultrasound device, per oz |
13 |
12 |
$0.00 |