| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Straight tip urine catheter |
9,446 |
8,719 |
$1.42M |
| T4534 |
Youth size pull-on |
8,247 |
8,026 |
$1.38M |
| T4522 |
Adult size brief/diaper med |
9,818 |
9,611 |
$1.26M |
| T4537 |
Reusable underpad bed size |
26,583 |
25,810 |
$1.06M |
| T4523 |
Adult size brief/diaper lg |
7,617 |
7,428 |
$1.06M |
| A4353 |
Intermittent urinary cath |
2,412 |
2,225 |
$1.05M |
| A4927 |
Non-sterile gloves |
47,584 |
45,158 |
$944K |
| T4527 |
Adult size pull-on lg |
6,536 |
6,249 |
$778K |
| T4535 |
Disposable liner/shield/pad |
12,297 |
11,728 |
$655K |
| T4526 |
Adult size pull-on med |
5,866 |
5,651 |
$648K |
| T4541 |
Large disposable underpad |
25,927 |
24,952 |
$593K |
| T4524 |
Adult size brief/diaper xl |
3,617 |
3,517 |
$545K |
| T4528 |
Adult size pull-on xl |
4,371 |
4,172 |
$500K |
| T4530 |
Ped size brief/diaper lg |
2,916 |
2,830 |
$404K |
| T4543 |
Adult disp brief/diap abv xl |
1,364 |
1,310 |
$403K |
| B4100 |
Food thickener oral |
6,421 |
6,065 |
$333K |
| A4352 |
Coude tip urinary catheter |
1,260 |
1,179 |
$301K |
| T4544 |
Adlt disp und/pull on abv xl |
1,096 |
1,032 |
$211K |
| T4521 |
Adult size brief/diaper sm |
1,252 |
1,195 |
$181K |
| A6212 |
Foam drg <=16 sq in w/border |
1,187 |
1,112 |
$150K |
| A4500 |
Below knee surgical stocking |
2,228 |
2,190 |
$122K |
| E1399 |
Durable medical equipment mi |
394 |
364 |
$111K |
| T4542 |
Small disposable underpad |
7,679 |
7,653 |
$87K |
| B4034 |
Enter feed supkit syr by day |
1,371 |
1,272 |
$63K |
| A4217 |
Sterile water/saline, 500 ml |
1,896 |
1,667 |
$62K |
| A4344 |
Cath indw foley 2 way silicn |
557 |
478 |
$57K |
| A4322 |
Irrigation syringe |
1,022 |
967 |
$35K |
| A4357 |
Bedside drainage bag |
3,393 |
3,206 |
$35K |
| B4036 |
Enteral feed sup kit grav by |
1,215 |
1,143 |
$35K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
91 |
89 |
$34K |
| A4332 |
Lube sterile packet |
3,722 |
3,558 |
$33K |
| A6402 |
Sterile gauze <= 16 sq in |
1,440 |
1,255 |
$18K |
| A4409 |
Ost skn barr convex <=4 sq i |
371 |
341 |
$16K |
| A4402 |
Lubricant per ounce |
2,424 |
2,205 |
$11K |
| A4349 |
Disposable male external cat |
558 |
517 |
$11K |
| A4310 |
Insert tray w/o bag/cath |
83 |
76 |
$9K |
| A4335 |
Incontinence supply |
618 |
503 |
$9K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
141 |
129 |
$8K |
| A4385 |
Ost skn barrier sld ext wear |
193 |
182 |
$8K |
| E0325 |
Urinal male jug-type |
1,456 |
1,398 |
$7K |
| A4452 |
Waterproof tape |
723 |
623 |
$7K |
| A4358 |
Urinary leg or abdomen bag |
1,194 |
1,072 |
$7K |
| A5120 |
Skin barrier, wipe or swab |
1,095 |
1,003 |
$6K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
35 |
29 |
$5K |
| A6216 |
Non-sterile gauze<=16 sq in |
711 |
667 |
$5K |
| A5063 |
Drain ostomy pouch w/flange |
114 |
104 |
$3K |
| A4450 |
Non-waterproof tape |
745 |
628 |
$3K |
| T4540 |
Reusable underpad chair size |
137 |
137 |
$2K |
| A4456 |
Adhesive remover, wipes |
313 |
294 |
$2K |
| A4320 |
Irrigation tray |
75 |
63 |
$2K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
50 |
49 |
$2K |
| A4338 |
Indwelling catheter latex |
81 |
75 |
$1K |
| A4554 |
Disposable underpads |
89 |
84 |
$965.84 |
| A4333 |
Urinary cath anchor device |
232 |
227 |
$892.23 |
| A4216 |
Sterile water/saline, 10 ml |
30 |
26 |
$860.80 |
| A4362 |
Solid skin barrier |
12 |
12 |
$675.66 |
| A4553 |
Nondisp underpads, all sizes |
12 |
12 |
$520.80 |
| A4406 |
Pectin based ostomy paste |
85 |
74 |
$510.75 |
| A4520 |
Incontinence garment anytype |
219 |
189 |
$196.71 |