| 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 |
1,633 |
1,581 |
$638K |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
545 |
529 |
$254K |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
394 |
377 |
$229K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
253 |
250 |
$93K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
510 |
454 |
$45K |
| E0784 |
External ambulatory infusion pump, insulin |
119 |
106 |
$38K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
325 |
302 |
$16K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
241 |
211 |
$12K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
200 |
189 |
$10K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
151 |
135 |
$9K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
96 |
91 |
$8K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
564 |
508 |
$8K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
81 |
78 |
$6K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
237 |
233 |
$5K |
| A4456 |
Adhesive remover, wipes, any type, each |
610 |
561 |
$3K |
| A5120 |
Skin barrier, wipes or swabs, each |
788 |
720 |
$3K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
213 |
154 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
528 |
425 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
135 |
118 |
$2K |
| 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 |
38 |
26 |
$903.80 |
| A4371 |
Ostomy skin barrier, powder, per oz |
278 |
252 |
$703.73 |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
32 |
24 |
$630.40 |
| A6260 |
Wound cleansers, any type, any size |
46 |
36 |
$615.97 |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
89 |
81 |
$600.00 |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
12 |
12 |
$212.30 |
| A4927 |
Gloves, non-sterile, per 100 |
69 |
63 |
$137.90 |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
12 |
12 |
$67.12 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
26 |
24 |
$0.00 |