| 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 |
5,889 |
3,324 |
$1.82M |
| E0784 |
External ambulatory infusion pump, insulin |
1,458 |
1,014 |
$1.32M |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
12,186 |
8,774 |
$1.23M |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
8,554 |
5,479 |
$889K |
| 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 |
2,468 |
1,916 |
$711K |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
1,380 |
685 |
$699K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
6,746 |
6,195 |
$589K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
7,125 |
6,048 |
$587K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
1,091 |
888 |
$586K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
8,388 |
7,589 |
$559K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
5,994 |
5,117 |
$545K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
5,124 |
3,866 |
$519K |
| A4554 |
Disposable underpads, all sizes |
16,297 |
13,959 |
$508K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
4,494 |
3,861 |
$506K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
4,381 |
3,962 |
$491K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
4,660 |
3,934 |
$455K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
11,201 |
9,215 |
$451K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
8,064 |
7,263 |
$422K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
12,241 |
8,806 |
$371K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
3,860 |
3,040 |
$362K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
1,626 |
1,325 |
$326K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,964 |
1,851 |
$281K |
| A6210 |
Foam 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 |
1,830 |
1,439 |
$226K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,089 |
1,751 |
$208K |
| A4927 |
Gloves, non-sterile, per 100 |
16,685 |
14,112 |
$204K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
1,815 |
1,606 |
$196K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,317 |
2,051 |
$193K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
1,954 |
1,509 |
$160K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
5,560 |
5,119 |
$157K |
| 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 |
2,440 |
1,970 |
$146K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
3,705 |
3,331 |
$145K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
2,623 |
2,350 |
$135K |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
291 |
131 |
$110K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
1,416 |
1,278 |
$83K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
2,854 |
2,293 |
$74K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
2,010 |
1,813 |
$68K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
660 |
441 |
$67K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
850 |
732 |
$65K |
| A4452 |
Tape, waterproof, per 18 square inches |
4,020 |
3,374 |
$57K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
482 |
417 |
$56K |
| A4456 |
Adhesive remover, wipes, any type, each |
7,602 |
6,892 |
$54K |
| A4410 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each |
429 |
382 |
$48K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
3,014 |
2,773 |
$47K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
541 |
501 |
$46K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
677 |
544 |
$45K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
502 |
369 |
$39K |
| A5120 |
Skin barrier, wipes or swabs, each |
7,798 |
7,123 |
$39K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
675 |
622 |
$38K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
364 |
234 |
$38K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
5,294 |
4,671 |
$35K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
299 |
221 |
$34K |
| A4231 |
Infusion set for external insulin pump, needle type |
480 |
303 |
$25K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
1,648 |
1,548 |
$23K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
415 |
371 |
$19K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,613 |
2,186 |
$18K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
3,992 |
3,470 |
$17K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
133 |
95 |
$16K |
| A4224 |
Supplies for maintenance of insulin infusion catheter, per week |
499 |
408 |
$15K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
352 |
263 |
$15K |
| A4371 |
Ostomy skin barrier, powder, per oz |
3,057 |
2,746 |
$14K |
| A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
391 |
334 |
$12K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,805 |
1,472 |
$12K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
496 |
409 |
$12K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
1,232 |
1,083 |
$12K |
| A4367 |
Ostomy belt, each |
2,079 |
1,889 |
$11K |
| A4322 |
Irrigation syringe, bulb or piston, each |
665 |
561 |
$10K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
857 |
752 |
$10K |
| A4402 |
Lubricant, per ounce |
2,694 |
2,472 |
$9K |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
316 |
259 |
$9K |
| A4373 |
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each |
101 |
97 |
$9K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
90 |
73 |
$9K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
98 |
67 |
$8K |
| A4225 |
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each |
408 |
337 |
$7K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
231 |
167 |
$7K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
1,512 |
1,225 |
$6K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
104 |
92 |
$5K |
| A6545 |
Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each |
76 |
67 |
$5K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
137 |
122 |
$5K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,307 |
1,038 |
$4K |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
1,096 |
969 |
$4K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
686 |
578 |
$3K |
| A4259 |
Lancets, per box of 100 |
224 |
204 |
$3K |
| A4408 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each |
26 |
26 |
$3K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
49 |
44 |
$3K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
366 |
295 |
$3K |
| A6452 |
High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard |
28 |
13 |
$2K |
| A4245 |
Alcohol wipes, per box |
1,210 |
1,039 |
$2K |
| A6260 |
Wound cleansers, any type, any size |
196 |
158 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
179 |
135 |
$2K |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
537 |
501 |
$1K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
12 |
12 |
$1K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
35 |
28 |
$904.42 |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
16 |
12 |
$708.36 |
| A4332 |
Lubricant, individual sterile packet, each |
64 |
63 |
$613.07 |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
20 |
16 |
$403.49 |
| A6441 |
Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard |
23 |
14 |
$254.89 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
43 |
36 |
$238.81 |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
16 |
13 |
$193.46 |
| A4311 |
Insertion tray without drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
13 |
13 |
$143.40 |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
13 |
12 |
$58.45 |
| A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
12 |
12 |
$24.76 |
| T4541 |
Incontinence product, disposable underpad, large, each |
19 |
12 |
$0.00 |