| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4385 |
Ost skn barrier sld ext wear |
1,170 |
922 |
$24K |
| A4409 |
Ost skn barr convex <=4 sq i |
700 |
550 |
$22K |
| A4362 |
Solid skin barrier |
807 |
649 |
$15K |
| A4407 |
Ext wear ost skn barr <=4sq" |
320 |
276 |
$13K |
| A4425 |
Ost pch drain for barrier fl |
533 |
449 |
$9K |
| A5063 |
Drain ostomy pouch w/flange |
336 |
263 |
$4K |
| A4394 |
Ostomy pouch liq deodorant |
784 |
622 |
$4K |
| A4456 |
Adhesive remover, wipes |
1,220 |
975 |
$4K |
| A4406 |
Pectin based ostomy paste |
607 |
483 |
$4K |
| A5120 |
Skin barrier, wipe or swab |
1,182 |
939 |
$3K |
| A4239 |
Non-adju cgm supply allow |
89 |
61 |
$2K |
| A5056 |
1 pc ost pouch w filter |
25 |
24 |
$2K |
| A4357 |
Bedside drainage bag |
309 |
225 |
$1K |
| A4371 |
Skin barrier powder per oz |
667 |
545 |
$966.52 |
| A4367 |
Ostomy belt |
277 |
242 |
$665.33 |
| A4349 |
Disposable male external cat |
81 |
52 |
$532.73 |
| A4455 |
Adhesive remover per ounce |
383 |
308 |
$529.26 |
| A4369 |
Skin barrier liquid per oz |
143 |
105 |
$127.36 |
| A4452 |
Waterproof tape |
13 |
12 |
$67.85 |