| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
2,029 |
1,885 |
$1.24M |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
54,430 |
40,074 |
$1.23M |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
1,939 |
1,907 |
$908K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
3,621 |
3,576 |
$697K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
3,259 |
3,004 |
$521K |
| E2101 |
Blood glucose monitor with integrated lancing/blood sample |
2,444 |
2,414 |
$336K |
| A4259 |
Lancets, per box of 100 |
34,316 |
33,522 |
$209K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
863 |
859 |
$106K |
| A4245 |
Alcohol wipes, per box |
26,153 |
25,810 |
$51K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
418 |
406 |
$33K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
336 |
334 |
$31K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
580 |
561 |
$29K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
400 |
321 |
$28K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
3,051 |
2,948 |
$27K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
408 |
396 |
$25K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
2,599 |
2,435 |
$19K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
169 |
161 |
$19K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
1,385 |
1,237 |
$18K |
| A4554 |
Disposable underpads, all sizes |
1,335 |
1,297 |
$16K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
256 |
250 |
$14K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,141 |
1,097 |
$14K |
| A4217 |
Sterile water/saline, 500 ml |
925 |
880 |
$13K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
806 |
794 |
$13K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,443 |
1,410 |
$12K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,492 |
1,449 |
$10K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
762 |
707 |
$9K |
| A4332 |
Lubricant, individual sterile packet, each |
1,331 |
1,277 |
$8K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
969 |
941 |
$8K |
| A4927 |
Gloves, non-sterile, per 100 |
1,272 |
1,154 |
$7K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
126 |
124 |
$6K |
| A4322 |
Irrigation syringe, bulb or piston, each |
291 |
281 |
$5K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
25 |
24 |
$4K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
26 |
24 |
$2K |
| A4371 |
Ostomy skin barrier, powder, per oz |
451 |
442 |
$2K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
291 |
268 |
$2K |
| A4256 |
Normal, low and high calibrator solution / chips |
667 |
664 |
$1K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
13 |
13 |
$1K |
| A4258 |
Spring-powered device for lancet, each |
628 |
622 |
$831.89 |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
13 |
12 |
$620.43 |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
13 |
12 |
$579.70 |
| A4247 |
Betadine or iodine swabs/wipes, per box |
62 |
62 |
$314.08 |
| A4402 |
Lubricant, per ounce |
16 |
12 |
$91.03 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
12 |
12 |
$62.27 |