| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0553 |
Ther cgm supply allowance |
13,447 |
13,112 |
$1.35M |
| A4239 |
Non-adju cgm supply allow |
12,530 |
11,317 |
$770K |
| A9276 |
Disposable sensor, cgm sys |
2,653 |
2,620 |
$470K |
| A9277 |
External transmitter, cgm |
570 |
555 |
$294K |
| T4534 |
Youth size pull-on |
1,919 |
1,849 |
$242K |
| T4527 |
Adult size pull-on lg |
926 |
897 |
$94K |
| B4161 |
Ef ped hydrolyzed/amino acid |
307 |
270 |
$94K |
| T4533 |
Youth size brief/diaper |
906 |
865 |
$94K |
| K0554 |
Ther cgm receiver/monitor |
1,155 |
1,093 |
$87K |
| T4526 |
Adult size pull-on med |
799 |
776 |
$71K |
| A9278 |
External receiver, cgm sys |
145 |
142 |
$64K |
| T4535 |
Disposable liner/shield/pad |
1,442 |
1,402 |
$63K |
| T4528 |
Adult size pull-on xl |
568 |
558 |
$58K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
239 |
223 |
$50K |
| T4541 |
Large disposable underpad |
1,916 |
1,840 |
$36K |
| E2103 |
Non-adju cgm receiver/mon |
374 |
342 |
$23K |
| T4532 |
Ped size pull-on lg |
249 |
224 |
$22K |
| T4537 |
Reusable underpad bed size |
540 |
527 |
$19K |
| T4522 |
Adult size brief/diaper med |
108 |
104 |
$12K |
| A4927 |
Non-sterile gloves |
586 |
564 |
$9K |
| A6212 |
Foam drg <=16 sq in w/border |
57 |
54 |
$7K |
| B4150 |
Ef complet w/intact nutrient |
51 |
51 |
$5K |
| A4670 |
Automatic bp monitor, dial |
74 |
74 |
$4K |
| T4521 |
Adult size brief/diaper sm |
40 |
40 |
$4K |
| A6402 |
Sterile gauze <= 16 sq in |
468 |
437 |
$3K |
| T4543 |
Adult disp brief/diap abv xl |
12 |
12 |
$3K |
| T4525 |
Adult size pull-on sm |
25 |
25 |
$3K |
| E0570 |
Nebulizer with compression |
34 |
33 |
$3K |
| A5120 |
Skin barrier, wipe or swab |
398 |
381 |
$2K |
| A4351 |
Straight tip urine catheter |
15 |
14 |
$2K |
| A6446 |
Conform band s w>=3" <5"/yd |
40 |
36 |
$1K |
| T4524 |
Adult size brief/diaper xl |
12 |
12 |
$1K |
| A4456 |
Adhesive remover, wipes |
243 |
231 |
$938.09 |
| A4394 |
Ostomy pouch liq deodorant |
37 |
37 |
$709.55 |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
12 |
12 |
$570.65 |
| A4216 |
Sterile water/saline, 10 ml |
27 |
25 |
$553.43 |
| A5063 |
Drain ostomy pouch w/flange |
13 |
13 |
$363.50 |
| A4660 |
Sphyg/bp app w cuff and stet |
12 |
12 |
$234.82 |
| A4253 |
Blood glucose/reagent strips |
14 |
14 |
$117.30 |
| A4450 |
Non-waterproof tape |
53 |
53 |
$89.72 |
| A4371 |
Skin barrier powder per oz |
24 |
24 |
$78.21 |
| A4335 |
Incontinence supply |
280 |
275 |
$60.17 |
| A4364 |
Adhesive, liquid or equal |
13 |
13 |
$57.68 |