| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
2,410 |
2,347 |
$983K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
2,950 |
2,887 |
$515K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
514 |
499 |
$282K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,110 |
1,046 |
$64K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
783 |
727 |
$44K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
554 |
521 |
$42K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
645 |
602 |
$39K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
657 |
615 |
$38K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
478 |
455 |
$38K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
592 |
549 |
$32K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
790 |
772 |
$23K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
90 |
88 |
$19K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,448 |
1,351 |
$12K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,628 |
1,622 |
$12K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
107 |
107 |
$12K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
124 |
122 |
$12K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
597 |
569 |
$11K |
| A4554 |
Disposable underpads, all sizes |
245 |
232 |
$11K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
253 |
239 |
$9K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
299 |
282 |
$6K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
164 |
158 |
$5K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
359 |
353 |
$5K |
| A4402 |
Lubricant, per ounce |
2,120 |
1,931 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
797 |
755 |
$3K |
| A4367 |
Ostomy belt, each |
481 |
457 |
$3K |
| A4371 |
Ostomy skin barrier, powder, per oz |
705 |
656 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
128 |
126 |
$1K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
210 |
201 |
$1K |
| A4399 |
Ostomy irrigation supply; cone/catheter, with or without brush |
100 |
91 |
$1K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
428 |
427 |
$1K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
197 |
197 |
$984.00 |
| A4389 |
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each |
12 |
12 |
$912.80 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
71 |
69 |
$662.57 |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
17 |
12 |
$432.14 |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
133 |
125 |
$429.84 |
| A4452 |
Tape, waterproof, per 18 square inches |
12 |
12 |
$264.80 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
26 |
24 |
$79.65 |