| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9276 |
Disposable sensor, cgm sys |
1,323 |
1,229 |
$363K |
| A9277 |
External transmitter, cgm |
419 |
395 |
$184K |
| K0553 |
Ther cgm supply allowance |
943 |
861 |
$155K |
| L4361 |
Pneuma/vac walk boot pre ots |
630 |
567 |
$114K |
| A9274 |
Ext amb insulin delivery sys |
175 |
152 |
$82K |
| E0114 |
Crutch underarm pair no wood |
1,588 |
1,508 |
$46K |
| L3809 |
Whfo w/o joints pre ots |
259 |
243 |
$43K |
| L3908 |
Who cock-up nonmolde pre ots |
871 |
792 |
$36K |
| A4230 |
Infus insulin pump non needl |
204 |
170 |
$36K |
| L1830 |
Ko immob canvas long pre ots |
518 |
471 |
$30K |
| L3670 |
So acro/clav can web pre ots |
605 |
552 |
$26K |
| A4351 |
Straight tip urine catheter |
317 |
222 |
$25K |
| A4239 |
Non-adju cgm supply allow |
104 |
67 |
$10K |
| L3260 |
Ambulatory surgical boot eac |
162 |
145 |
$8K |
| E0784 |
Ext amb infusn pump insulin |
16 |
12 |
$7K |
| A4385 |
Ost skn barrier sld ext wear |
496 |
322 |
$7K |
| A4225 |
Sup/ext insulin inf pump syr |
230 |
199 |
$5K |
| A6446 |
Conform band s w>=3" <5"/yd |
160 |
136 |
$3K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
44 |
41 |
$2K |
| A4357 |
Bedside drainage bag |
602 |
368 |
$1K |
| A5120 |
Skin barrier, wipe or swab |
1,285 |
807 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
338 |
278 |
$1K |
| A6212 |
Foam drg <=16 sq in w/border |
15 |
14 |
$993.42 |
| A4456 |
Adhesive remover, wipes |
718 |
430 |
$749.26 |
| A6196 |
Alginate dressing <=16 sq in |
14 |
14 |
$730.33 |
| A4409 |
Ost skn barr convex <=4 sq i |
46 |
28 |
$602.80 |
| A4452 |
Waterproof tape |
65 |
53 |
$320.08 |
| A4425 |
Ost pch drain for barrier fl |
20 |
14 |
$186.02 |
| A4362 |
Solid skin barrier |
24 |
12 |
$143.63 |
| A4394 |
Ostomy pouch liq deodorant |
38 |
24 |
$123.15 |
| A4371 |
Skin barrier powder per oz |
171 |
114 |
$107.99 |
| A5063 |
Drain ostomy pouch w/flange |
23 |
13 |
$104.08 |
| A4358 |
Urinary leg or abdomen bag |
12 |
12 |
$102.58 |
| A4406 |
Pectin based ostomy paste |
71 |
40 |
$62.75 |
| A4927 |
Non-sterile gloves |
19 |
15 |
$15.56 |
| A4367 |
Ostomy belt |
18 |
12 |
$5.68 |
| L3674 |
So airplane w/wo joint cf |
176 |
117 |
$0.00 |
| L3675 |
So vest canvas/web pre ots |
68 |
28 |
$0.00 |
| L3660 |
So 8 ab rstr can/web pre ots |
865 |
563 |
$0.00 |