| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6530 |
Compression stocking bk18-30 |
1,108 |
947 |
$64K |
| A4554 |
Disposable underpads |
643 |
597 |
$32K |
| T4535 |
Disposable liner/shield/pad |
407 |
376 |
$30K |
| A4927 |
Non-sterile gloves |
1,099 |
772 |
$29K |
| A4362 |
Solid skin barrier |
718 |
573 |
$25K |
| A4425 |
Ost pch drain for barrier fl |
440 |
354 |
$21K |
| A4409 |
Ost skn barr convex <=4 sq i |
266 |
227 |
$20K |
| A4385 |
Ost skn barrier sld ext wear |
344 |
264 |
$17K |
| A6533 |
Gc stocking thighlngth 18-30 |
93 |
88 |
$6K |
| A4456 |
Adhesive remover, wipes |
824 |
673 |
$5K |
| A4394 |
Ostomy pouch liq deodorant |
291 |
244 |
$4K |
| A6250 |
Skin seal protect moisturizr |
81 |
67 |
$3K |
| A4407 |
Ext wear ost skn barr <=4sq" |
33 |
27 |
$3K |
| A4351 |
Straight tip urine catheter |
27 |
25 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
328 |
267 |
$1K |
| A4670 |
Automatic bp monitor, dial |
17 |
14 |
$1K |
| A4357 |
Bedside drainage bag |
189 |
147 |
$838.62 |
| A4310 |
Insert tray w/o bag/cath |
29 |
24 |
$19.44 |