| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
1,434 |
857 |
$664K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
5,341 |
4,306 |
$344K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
7,036 |
3,870 |
$303K |
| A4238 |
Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
727 |
524 |
$92K |
| E0570 |
Nebulizer, with compressor |
1,344 |
980 |
$24K |
| A4554 |
Disposable underpads, all sizes |
1,253 |
918 |
$24K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
333 |
213 |
$17K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
220 |
99 |
$11K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
111 |
90 |
$9K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
1,671 |
877 |
$4K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
19 |
13 |
$2K |
| E2102 |
Adjunctive, non-implanted continuous glucose monitor or receiver |
19 |
14 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
61 |
59 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
246 |
154 |
$1K |
| K0003 |
Lightweight wheelchair |
168 |
103 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
113 |
97 |
$890.07 |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
21 |
12 |
$826.90 |
| A4332 |
Lubricant, individual sterile packet, each |
18 |
13 |
$485.62 |
| A4259 |
Lancets, per box of 100 |
58 |
56 |
$250.56 |
| S8490 |
Insulin syringes (100 syringes, any size) |
14 |
13 |
$245.70 |
| A7015 |
Aerosol mask, used with dme nebulizer |
136 |
112 |
$108.51 |
| A4245 |
Alcohol wipes, per box |
44 |
43 |
$84.00 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
22 |
14 |
$17.51 |