| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
2,410 |
2,347 |
$983K |
| A4351 |
Straight tip urine catheter |
2,950 |
2,887 |
$515K |
| A4352 |
Coude tip urinary catheter |
514 |
499 |
$282K |
| A4385 |
Ost skn barrier sld ext wear |
1,110 |
1,046 |
$64K |
| A4362 |
Solid skin barrier |
783 |
727 |
$44K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
554 |
521 |
$42K |
| A4425 |
Ost pch drain for barrier fl |
645 |
602 |
$39K |
| A4409 |
Ost skn barr convex <=4 sq i |
657 |
615 |
$38K |
| A4407 |
Ext wear ost skn barr <=4sq" |
478 |
455 |
$38K |
| A5063 |
Drain ostomy pouch w/flange |
592 |
549 |
$32K |
| A4357 |
Bedside drainage bag |
790 |
772 |
$23K |
| A5057 |
1 pc ost pou w built-in conv |
90 |
88 |
$19K |
| A4456 |
Adhesive remover, wipes |
1,448 |
1,351 |
$12K |
| A5120 |
Skin barrier, wipe or swab |
1,628 |
1,622 |
$12K |
| A5121 |
Solid skin barrier 6x6 |
107 |
107 |
$12K |
| A4419 |
Ost pch for bar w flange/flt |
124 |
122 |
$12K |
| A4394 |
Ostomy pouch liq deodorant |
597 |
569 |
$11K |
| A4554 |
Disposable underpads |
245 |
232 |
$11K |
| A4432 |
Os pch urine w bar/fange/tap |
253 |
239 |
$9K |
| A4406 |
Pectin based ostomy paste |
299 |
282 |
$6K |
| A4344 |
Cath indw foley 2 way silicn |
164 |
158 |
$5K |
| A4358 |
Urinary leg or abdomen bag |
359 |
353 |
$5K |
| A4402 |
Lubricant per ounce |
2,120 |
1,931 |
$5K |
| A4927 |
Non-sterile gloves |
797 |
755 |
$3K |
| A4367 |
Ostomy belt |
481 |
457 |
$3K |
| A4371 |
Skin barrier powder per oz |
705 |
656 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
128 |
126 |
$1K |
| A4310 |
Insert tray w/o bag/cath |
210 |
201 |
$1K |
| A4399 |
Ostomy irrig cone/cath w brs |
100 |
91 |
$1K |
| A4455 |
Adhesive remover per ounce |
428 |
427 |
$1K |
| A6216 |
Non-sterile gauze<=16 sq in |
197 |
197 |
$984.00 |
| A4389 |
Drainable pch w st wear barr |
12 |
12 |
$912.80 |
| A4333 |
Urinary cath anchor device |
71 |
69 |
$662.57 |
| A4349 |
Disposable male external cat |
17 |
12 |
$432.14 |
| A4369 |
Skin barrier liquid per oz |
133 |
125 |
$429.84 |
| A4452 |
Waterproof tape |
12 |
12 |
$264.80 |
| A4338 |
Indwelling catheter latex |
26 |
24 |
$79.65 |