| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
15,916 |
13,719 |
$1.36M |
| A4554 |
Disposable underpads, all sizes |
4,988 |
4,817 |
$314K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,035 |
1,845 |
$307K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,039 |
1,829 |
$307K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
1,398 |
1,283 |
$255K |
| A4259 |
Lancets, per box of 100 |
13,352 |
11,658 |
$235K |
| A4215 |
Needle, sterile, any size, each |
6,231 |
5,842 |
$157K |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
5,200 |
4,881 |
$145K |
| A4927 |
Gloves, non-sterile, per 100 |
3,925 |
3,761 |
$125K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
379 |
358 |
$88K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
1,456 |
695 |
$75K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
1,462 |
698 |
$61K |
| S8490 |
Insulin syringes (100 syringes, any size) |
973 |
934 |
$47K |
| A4256 |
Normal, low and high calibrator solution / chips |
6,440 |
5,547 |
$44K |
| K0552 |
Supplies for external non-insulin drug infusion pump, syringe type cartridge, sterile, each |
1,379 |
1,273 |
$43K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
266 |
248 |
$39K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
475 |
228 |
$35K |
| A4235 |
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each |
4,994 |
4,654 |
$20K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
178 |
164 |
$14K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
30 |
13 |
$6K |
| A4233 |
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each |
2,133 |
1,294 |
$806.38 |
| A4258 |
Spring-powered device for lancet, each |
77 |
52 |
$615.15 |
| K0603 |
Replacement battery for external infusion pump owned by patient, alkaline, 1.5 volt, each |
13 |
13 |
$12.10 |