| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4532 |
Ped size pull-on lg |
145,943 |
140,179 |
$16.15M |
| A4239 |
Non-adju cgm supply allow |
73,087 |
65,697 |
$4.73M |
| B4160 |
Ef ped caloric dense>/=0.7kc |
28,385 |
24,985 |
$3.53M |
| A4253 |
Blood glucose/reagent strips |
35,854 |
34,107 |
$2.35M |
| K0553 |
Ther cgm supply allowance |
57,695 |
49,042 |
$2.14M |
| T4530 |
Ped size brief/diaper lg |
22,330 |
21,424 |
$2.09M |
| B4100 |
Food thickener oral |
19,469 |
16,892 |
$1.70M |
| B4150 |
Ef complet w/intact nutrient |
13,190 |
11,329 |
$1.62M |
| T4527 |
Adult size pull-on lg |
12,804 |
12,407 |
$1.24M |
| T4526 |
Adult size pull-on med |
12,295 |
11,753 |
$1.06M |
| A4554 |
Disposable underpads |
33,745 |
32,481 |
$729K |
| T4528 |
Adult size pull-on xl |
7,232 |
6,883 |
$697K |
| A9276 |
Disposable sensor, cgm sys |
2,355 |
2,157 |
$679K |
| T4531 |
Ped size pull-on sm/med |
5,484 |
5,308 |
$572K |
| T4535 |
Disposable liner/shield/pad |
13,299 |
12,841 |
$543K |
| A4259 |
Lancets per box |
31,041 |
29,597 |
$524K |
| E2103 |
Non-adju cgm receiver/mon |
5,810 |
5,109 |
$505K |
| A4351 |
Straight tip urine catheter |
2,425 |
2,279 |
$422K |
| B4152 |
Ef calorie dense>/=1.5kcal |
2,175 |
1,900 |
$346K |
| T4544 |
Adlt disp und/pull on abv xl |
2,341 |
2,241 |
$233K |
| K0554 |
Ther cgm receiver/monitor |
4,694 |
4,007 |
$223K |
| T4522 |
Adult size brief/diaper med |
1,704 |
1,614 |
$163K |
| A9278 |
External receiver, cgm sys |
228 |
211 |
$104K |
| A9274 |
Ext amb insulin delivery sys |
95 |
82 |
$75K |
| A4335 |
Incontinence supply |
11,345 |
10,749 |
$62K |
| T4523 |
Adult size brief/diaper lg |
694 |
657 |
$61K |
| T4521 |
Adult size brief/diaper sm |
608 |
589 |
$50K |
| T4525 |
Adult size pull-on sm |
849 |
827 |
$44K |
| A4927 |
Non-sterile gloves |
4,368 |
4,113 |
$26K |
| E0607 |
Blood glucose monitor home |
270 |
260 |
$20K |
| A9277 |
External transmitter, cgm |
42 |
39 |
$20K |
| T4534 |
Youth size pull-on |
147 |
142 |
$9K |
| A4402 |
Lubricant per ounce |
1,808 |
1,709 |
$9K |
| A4256 |
Calibrator solution/chips |
814 |
732 |
$4K |
| A9999 |
Dme supply or accessory, nos |
19 |
12 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
13 |
12 |
$46.33 |
| A4245 |
Alcohol wipes per box |
40 |
36 |
$41.85 |