| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
1,108 |
947 |
$64K |
| A4554 |
Disposable underpads, all sizes |
643 |
597 |
$32K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
407 |
376 |
$30K |
| A4927 |
Gloves, non-sterile, per 100 |
1,099 |
772 |
$29K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
718 |
573 |
$25K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
440 |
354 |
$21K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
266 |
227 |
$20K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
344 |
264 |
$17K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
93 |
88 |
$6K |
| A4456 |
Adhesive remover, wipes, any type, each |
824 |
673 |
$5K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
291 |
244 |
$4K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
81 |
67 |
$3K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
33 |
27 |
$3K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
27 |
25 |
$2K |
| A5120 |
Skin barrier, wipes or swabs, each |
328 |
267 |
$1K |
| A4670 |
Automatic blood pressure monitor |
17 |
14 |
$1K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
189 |
147 |
$838.62 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
29 |
24 |
$19.44 |