| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
2,029 |
1,885 |
$1.24M |
| A4253 |
Blood glucose/reagent strips |
54,430 |
40,074 |
$1.23M |
| K0553 |
Ther cgm supply allowance |
1,939 |
1,907 |
$908K |
| A4239 |
Non-adju cgm supply allow |
3,621 |
3,576 |
$697K |
| A4351 |
Straight tip urine catheter |
3,259 |
3,004 |
$521K |
| E2101 |
Bld glucose monitor w lance |
2,444 |
2,414 |
$336K |
| A4259 |
Lancets per box |
34,316 |
33,522 |
$209K |
| E0603 |
Electric breast pump |
863 |
859 |
$106K |
| A4245 |
Alcohol wipes per box |
26,153 |
25,810 |
$51K |
| A4385 |
Ost skn barrier sld ext wear |
418 |
406 |
$33K |
| T4534 |
Youth size pull-on |
336 |
334 |
$31K |
| A4362 |
Solid skin barrier |
580 |
561 |
$29K |
| A4344 |
Cath indw foley 2 way silicn |
400 |
321 |
$28K |
| A6250 |
Skin seal protect moisturizr |
3,051 |
2,948 |
$27K |
| T4526 |
Adult size pull-on med |
408 |
396 |
$25K |
| A4357 |
Bedside drainage bag |
2,599 |
2,435 |
$19K |
| A4230 |
Infus insulin pump non needl |
169 |
161 |
$19K |
| A4310 |
Insert tray w/o bag/cath |
1,385 |
1,237 |
$18K |
| A4554 |
Disposable underpads |
1,335 |
1,297 |
$16K |
| T4525 |
Adult size pull-on sm |
256 |
250 |
$14K |
| A4456 |
Adhesive remover, wipes |
1,141 |
1,097 |
$14K |
| A4217 |
Sterile water/saline, 500 ml |
925 |
880 |
$13K |
| A4394 |
Ostomy pouch liq deodorant |
806 |
794 |
$13K |
| A5120 |
Skin barrier, wipe or swab |
1,443 |
1,410 |
$12K |
| A4358 |
Urinary leg or abdomen bag |
1,492 |
1,449 |
$10K |
| A4406 |
Pectin based ostomy paste |
762 |
707 |
$9K |
| A4332 |
Lube sterile packet |
1,331 |
1,277 |
$8K |
| A4338 |
Indwelling catheter latex |
969 |
941 |
$8K |
| A4927 |
Non-sterile gloves |
1,272 |
1,154 |
$7K |
| A4349 |
Disposable male external cat |
126 |
124 |
$6K |
| A4322 |
Irrigation syringe |
291 |
281 |
$5K |
| E2103 |
Non-adju cgm receiver/mon |
25 |
24 |
$4K |
| A5061 |
Pouch drainable w barrier at |
26 |
24 |
$2K |
| A4371 |
Skin barrier powder per oz |
451 |
442 |
$2K |
| A4333 |
Urinary cath anchor device |
291 |
268 |
$2K |
| A4256 |
Calibrator solution/chips |
667 |
664 |
$1K |
| A4352 |
Coude tip urinary catheter |
13 |
13 |
$1K |
| A4258 |
Lancet device each |
628 |
622 |
$831.89 |
| A5063 |
Drain ostomy pouch w/flange |
13 |
12 |
$620.43 |
| A4424 |
Ost pch drain w bar & filter |
13 |
12 |
$579.70 |
| A4247 |
Betadine/iodine swabs/wipes |
62 |
62 |
$314.08 |
| A4402 |
Lubricant per ounce |
16 |
12 |
$91.03 |
| A6402 |
Sterile gauze <= 16 sq in |
12 |
12 |
$62.27 |