| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Straight tip urine catheter |
313 |
299 |
$14K |
| A4409 |
Ost skn barr convex <=4 sq i |
349 |
338 |
$12K |
| A4385 |
Ost skn barrier sld ext wear |
475 |
458 |
$11K |
| T4541 |
Large disposable underpad |
230 |
225 |
$8K |
| A4927 |
Non-sterile gloves |
350 |
347 |
$5K |
| T4537 |
Reusable underpad bed size |
148 |
148 |
$5K |
| T4526 |
Adult size pull-on med |
58 |
57 |
$4K |
| A4357 |
Bedside drainage bag |
488 |
475 |
$3K |
| A4335 |
Incontinence supply |
142 |
139 |
$3K |
| A4456 |
Adhesive remover, wipes |
609 |
595 |
$2K |
| T4534 |
Youth size pull-on |
27 |
27 |
$2K |
| A4407 |
Ext wear ost skn barr <=4sq" |
29 |
25 |
$2K |
| T4527 |
Adult size pull-on lg |
12 |
12 |
$1K |
| T4535 |
Disposable liner/shield/pad |
25 |
25 |
$884.16 |
| A5120 |
Skin barrier, wipe or swab |
392 |
379 |
$854.92 |
| A5063 |
Drain ostomy pouch w/flange |
12 |
12 |
$543.48 |
| A4425 |
Ost pch drain for barrier fl |
14 |
13 |
$187.14 |
| A4362 |
Solid skin barrier |
12 |
12 |
$145.72 |
| A4371 |
Skin barrier powder per oz |
15 |
14 |
$21.24 |