| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
1,797 |
1,595 |
$878K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
4,774 |
4,450 |
$499K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
838 |
799 |
$249K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
779 |
718 |
$65K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
734 |
695 |
$62K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
732 |
698 |
$60K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
759 |
668 |
$58K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
422 |
369 |
$51K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
723 |
660 |
$46K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,172 |
1,146 |
$45K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
657 |
600 |
$45K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
403 |
392 |
$41K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
429 |
403 |
$40K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
785 |
746 |
$31K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
551 |
487 |
$29K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
864 |
787 |
$26K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
478 |
443 |
$24K |
| A4554 |
Disposable underpads, all sizes |
1,010 |
864 |
$24K |
| A4927 |
Gloves, non-sterile, per 100 |
2,259 |
1,986 |
$23K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
812 |
690 |
$21K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
198 |
194 |
$20K |
| A4332 |
Lubricant, individual sterile packet, each |
1,250 |
1,195 |
$19K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
285 |
267 |
$18K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
450 |
402 |
$16K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
423 |
342 |
$15K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
388 |
327 |
$15K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,394 |
1,248 |
$14K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
165 |
158 |
$12K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,076 |
916 |
$10K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
288 |
246 |
$9K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
765 |
689 |
$8K |
| A4217 |
Sterile water/saline, 500 ml |
411 |
390 |
$7K |
| A4402 |
Lubricant, per ounce |
1,640 |
1,571 |
$7K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
700 |
679 |
$6K |
| A4399 |
Ostomy irrigation supply; cone/catheter, with or without brush |
228 |
222 |
$4K |
| A4456 |
Adhesive remover, wipes, any type, each |
425 |
389 |
$4K |
| A4398 |
Ostomy irrigation supply; bag, each |
222 |
217 |
$4K |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
56 |
49 |
$4K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,036 |
947 |
$4K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
237 |
222 |
$4K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
252 |
229 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
242 |
207 |
$3K |
| A4367 |
Ostomy belt, each |
349 |
325 |
$2K |
| A4371 |
Ostomy skin barrier, powder, per oz |
614 |
556 |
$2K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
107 |
104 |
$2K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
28 |
27 |
$1K |
| A4373 |
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each |
13 |
13 |
$1K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
214 |
202 |
$403.87 |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
13 |
12 |
$332.46 |