| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 90378 |
|
1,069 |
931 |
$4.02M |
| A4231 |
Infusion insulin pump needle |
5,139 |
4,941 |
$663K |
| A9276 |
Disposable sensor, cgm sys |
752 |
695 |
$418K |
| E0603 |
Electric breast pump |
3,023 |
2,877 |
$302K |
| K0552 |
Sup/ext non-ins inf pump syr |
3,407 |
3,287 |
$238K |
| E0784 |
Ext amb infusn pump insulin |
54 |
53 |
$207K |
| A4225 |
Sup/ext insulin inf pump syr |
1,771 |
1,738 |
$125K |
| A9277 |
External transmitter, cgm |
212 |
196 |
$75K |
| J0585 |
Injection,onabotulinumtoxina |
5,277 |
5,120 |
$41K |
| J0878 |
Daptomycin injection |
128 |
52 |
$24K |
| A4224 |
Supply insulin inf cath/wk |
98 |
95 |
$19K |
| J1439 |
Inj ferric carboxymaltos 1mg |
990 |
805 |
$15K |
| J7323 |
Euflexxa inj per dose |
964 |
956 |
$14K |
| A6257 |
Transparent film <= 16 sq in |
39 |
39 |
$6K |
| J1642 |
Inj heparin sodium per 10 u |
345 |
273 |
$3K |
| J0588 |
Incobotulinumtoxin a |
149 |
149 |
$3K |
| J1726 |
Makena, 10 mg |
39 |
38 |
$3K |
| B4035 |
Enteral feed supp pump per d |
996 |
956 |
$3K |
| A4351 |
Straight tip urine catheter |
385 |
353 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
3,351 |
3,288 |
$2K |
| E1399 |
Durable medical equipment mi |
193 |
154 |
$2K |
| J1729 |
Inj hydroxyprogst capoat nos |
33 |
31 |
$2K |
| A4657 |
Syringe w/wo needle |
1,109 |
454 |
$895.41 |
| E0202 |
Phototherapy light w/ photom |
114 |
96 |
$853.20 |
| B9998 |
Enteral supp not otherwise c |
242 |
235 |
$746.29 |
| J1756 |
Iron sucrose injection |
657 |
603 |
$731.00 |
| E0163 |
Commode chair with fixed arm |
767 |
759 |
$693.84 |
| B9002 |
Enter nutr inf pump any type |
444 |
436 |
$592.70 |
| J3370 |
Vancomycin hcl injection |
47 |
14 |
$486.35 |
| A9278 |
External receiver, cgm sys |
30 |
27 |
$375.00 |
| A4670 |
Automatic bp monitor, dial |
65 |
64 |
$347.55 |
| T4541 |
Large disposable underpad |
813 |
775 |
$332.92 |
| E0118 |
Crutch substitute |
297 |
297 |
$331.66 |
| A5120 |
Skin barrier, wipe or swab |
2,149 |
2,089 |
$217.10 |
| A6402 |
Sterile gauze <= 16 sq in |
2,532 |
994 |
$144.87 |
| B4034 |
Enter feed supkit syr by day |
155 |
149 |
$115.34 |
| A4385 |
Ost skn barrier sld ext wear |
616 |
600 |
$93.45 |
| E0114 |
Crutch underarm pair no wood |
83 |
81 |
$88.68 |
| E0431 |
Portable gaseous 02 |
64 |
63 |
$83.16 |
| A4452 |
Waterproof tape |
398 |
381 |
$81.96 |
| E0156 |
Walker seat attachment |
817 |
808 |
$78.69 |
| J7040 |
Normal saline solution infus |
1,120 |
966 |
$56.06 |
| J7050 |
Normal saline solution infus |
2,220 |
1,978 |
$51.07 |
| E0240 |
Bath/shower chair |
354 |
349 |
$44.69 |
| J0696 |
Ceftriaxone sodium injection |
22 |
12 |
$42.24 |
| A4216 |
Sterile water/saline, 10 ml |
1,966 |
1,693 |
$34.60 |
| A4456 |
Adhesive remover, wipes |
900 |
882 |
$32.18 |
| E0776 |
Iv pole |
78 |
78 |
$28.08 |
| A4406 |
Pectin based ostomy paste |
37 |
37 |
$21.00 |
| E0100 |
Cane adjust/fixed with tip |
55 |
55 |
$20.92 |
| A4322 |
Irrigation syringe |
114 |
106 |
$11.92 |
| A4215 |
Sterile needle |
219 |
120 |
$6.80 |
| A4371 |
Skin barrier powder per oz |
127 |
127 |
$3.30 |
| A4450 |
Non-waterproof tape |
62 |
60 |
$0.90 |
| E0247 |
Trans bench w/wo comm open |
104 |
103 |
$0.00 |
| B4161 |
Ef ped hydrolyzed/amino acid |
95 |
90 |
$0.00 |
| B4088 |
Gastro/jejuno tube, low-pro |
62 |
61 |
$0.00 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
38 |
38 |
$0.00 |
| T4534 |
Youth size pull-on |
13 |
13 |
$0.00 |
| Q5104 |
Injection, renflexis |
13 |
12 |
$0.00 |
| J3490 |
Drugs unclassified injection |
64 |
28 |
$0.00 |
| A4209 |
5+ cc sterile syringe&needle |
13 |
12 |
$0.00 |
| Q5121 |
Inj. avsola, 10 mg |
14 |
14 |
$0.00 |
| A4409 |
Ost skn barr convex <=4 sq i |
53 |
49 |
$0.00 |
| A4362 |
Solid skin barrier |
168 |
167 |
$0.00 |
| J1745 |
Infliximab not biosimil 10mg |
161 |
143 |
$0.00 |
| A4649 |
Surgical supplies |
376 |
291 |
$0.00 |
| A4425 |
Ost pch drain for barrier fl |
126 |
121 |
$0.00 |
| A6216 |
Non-sterile gauze<=16 sq in |
122 |
120 |
$0.00 |
| J0692 |
Cefepime hcl for injection |
32 |
12 |
$0.00 |
| J2323 |
Natalizumab injection |
13 |
13 |
$0.00 |
| J3380 |
Inj vedolizumab iv 1 mg |
13 |
12 |
$0.00 |
| T4526 |
Adult size pull-on med |
24 |
24 |
$0.00 |
| T4528 |
Adult size pull-on xl |
14 |
14 |
$0.00 |
| J1750 |
Inj iron dextran |
12 |
12 |
$0.00 |