| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,684 |
1,383 |
$137K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,368 |
2,187 |
$130K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,025 |
904 |
$122K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,500 |
1,421 |
$104K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,443 |
1,337 |
$101K |
| A4927 |
Gloves, non-sterile, per 100 |
3,837 |
3,547 |
$67K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
430 |
383 |
$36K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,681 |
1,566 |
$36K |
| A4670 |
Automatic blood pressure monitor |
285 |
280 |
$14K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
448 |
402 |
$4K |
| A4332 |
Lubricant, individual sterile packet, each |
273 |
226 |
$2K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
457 |
332 |
$1K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
164 |
115 |
$159.63 |
| A4259 |
Lancets, per box of 100 |
12 |
12 |
$56.39 |