| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
79 |
55 |
$0.00 |
| A5122 |
Skin barrier; solid, 8 x 8 or equivalent, each |
32 |
26 |
$0.00 |
| A4408 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each |
66 |
43 |
$0.00 |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
142 |
110 |
$0.00 |
| A4375 |
Ostomy pouch, drainable, with faceplate attached, plastic, each |
46 |
38 |
$0.00 |