| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
985 |
956 |
$156K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
183 |
180 |
$46K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
237 |
231 |
$42K |
| 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 |
113 |
112 |
$22K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
306 |
302 |
$22K |
| A4554 |
Disposable underpads, all sizes |
529 |
507 |
$18K |
| A4452 |
Tape, waterproof, per 18 square inches |
364 |
360 |
$6K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
44 |
44 |
$5K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
470 |
467 |
$4K |
| A6260 |
Wound cleansers, any type, any size |
154 |
153 |
$4K |
| A6536 |
Gradient compression stocking, full length/chap style, 18-30 mmhg, each |
40 |
20 |
$3K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
13 |
13 |
$2K |
| A6224 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
54 |
54 |
$2K |
| A4670 |
Automatic blood pressure monitor |
74 |
73 |
$2K |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
341 |
335 |
$2K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
266 |
252 |
$2K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
65 |
65 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
54 |
54 |
$918.00 |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
12 |
12 |
$781.44 |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
12 |
12 |
$578.61 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
16 |
16 |
$146.27 |