| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
145,943 |
140,179 |
$16.15M |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
73,087 |
65,697 |
$4.73M |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
28,385 |
24,985 |
$3.53M |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
35,854 |
34,107 |
$2.35M |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
57,695 |
49,042 |
$2.14M |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
22,330 |
21,424 |
$2.09M |
| B4100 |
Food thickener, administered orally, per ounce |
19,469 |
16,892 |
$1.70M |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
13,190 |
11,329 |
$1.62M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12,804 |
12,407 |
$1.24M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
12,295 |
11,753 |
$1.06M |
| A4554 |
Disposable underpads, all sizes |
33,745 |
32,481 |
$729K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
7,232 |
6,883 |
$697K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
2,355 |
2,157 |
$679K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
5,484 |
5,308 |
$572K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
13,299 |
12,841 |
$543K |
| A4259 |
Lancets, per box of 100 |
31,041 |
29,597 |
$524K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
5,810 |
5,109 |
$505K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
2,425 |
2,279 |
$422K |
| B4152 |
Enteral formula, nutritionally complete, calorically dense (equal to or greater than 1.5 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
2,175 |
1,900 |
$346K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
2,341 |
2,241 |
$233K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
4,694 |
4,007 |
$223K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,704 |
1,614 |
$163K |
| A9278 |
Receiver (monitor); external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
228 |
211 |
$104K |
| A9274 |
External ambulatory insulin delivery system, disposable, each, includes all supplies and accessories |
95 |
82 |
$75K |
| A4335 |
Incontinence supply; miscellaneous |
11,345 |
10,749 |
$62K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
694 |
657 |
$61K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
608 |
589 |
$50K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
849 |
827 |
$44K |
| A4927 |
Gloves, non-sterile, per 100 |
4,368 |
4,113 |
$26K |
| E0607 |
Home blood glucose monitor |
270 |
260 |
$20K |
| A9277 |
Transmitter; external, for use with non-durable medical equipment interstitial continuous glucose monitoring system |
42 |
39 |
$20K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
147 |
142 |
$9K |
| A4402 |
Lubricant, per ounce |
1,808 |
1,709 |
$9K |
| A4256 |
Normal, low and high calibrator solution / chips |
814 |
732 |
$4K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
19 |
12 |
$2K |
| A5120 |
Skin barrier, wipes or swabs, each |
13 |
12 |
$46.33 |
| A4245 |
Alcohol wipes, per box |
40 |
36 |
$41.85 |