| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
1,633 |
1,581 |
$638K |
| A9277 |
External transmitter, cgm |
545 |
529 |
$254K |
| A9274 |
Ext amb insulin delivery sys |
394 |
377 |
$229K |
| A4230 |
Infus insulin pump non needl |
253 |
250 |
$93K |
| A4385 |
Ost skn barrier sld ext wear |
510 |
454 |
$45K |
| E0784 |
Ext amb infusn pump insulin |
119 |
106 |
$38K |
| A4425 |
Ost pch drain for barrier fl |
325 |
302 |
$16K |
| A4424 |
Ost pch drain w bar & filter |
241 |
211 |
$12K |
| A4362 |
Solid skin barrier |
200 |
189 |
$10K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
151 |
135 |
$9K |
| A4351 |
Straight tip urine catheter |
96 |
91 |
$8K |
| A4406 |
Pectin based ostomy paste |
564 |
508 |
$8K |
| A4409 |
Ost skn barr convex <=4 sq i |
81 |
78 |
$6K |
| A4225 |
Sup/ext insulin inf pump syr |
237 |
233 |
$5K |
| A4456 |
Adhesive remover, wipes |
610 |
561 |
$3K |
| A5120 |
Skin barrier, wipe or swab |
788 |
720 |
$3K |
| A6446 |
Conform band s w>=3" <5"/yd |
213 |
154 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
528 |
425 |
$3K |
| A4452 |
Waterproof tape |
135 |
118 |
$2K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
38 |
26 |
$903.80 |
| A4371 |
Skin barrier powder per oz |
278 |
252 |
$703.73 |
| A5063 |
Drain ostomy pouch w/flange |
32 |
24 |
$630.40 |
| A6260 |
Wound cleanser any type/size |
46 |
36 |
$615.97 |
| E0603 |
Electric breast pump |
89 |
81 |
$600.00 |
| K0552 |
Sup/ext non-ins inf pump syr |
12 |
12 |
$212.30 |
| A4927 |
Non-sterile gloves |
69 |
63 |
$137.90 |
| A4357 |
Bedside drainage bag |
12 |
12 |
$67.12 |
| A4394 |
Ostomy pouch liq deodorant |
26 |
24 |
$0.00 |