| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
6,025 |
5,555 |
$3.63M |
| A4351 |
Straight tip urine catheter |
7,407 |
6,477 |
$987K |
| T4523 |
Adult size brief/diaper lg |
7,274 |
6,895 |
$834K |
| A4352 |
Coude tip urinary catheter |
1,443 |
1,262 |
$702K |
| T4535 |
Disposable liner/shield/pad |
14,160 |
13,515 |
$665K |
| A4927 |
Non-sterile gloves |
35,927 |
34,314 |
$659K |
| T4527 |
Adult size pull-on lg |
5,779 |
5,584 |
$639K |
| T4526 |
Adult size pull-on med |
5,626 |
5,377 |
$590K |
| T4541 |
Large disposable underpad |
15,130 |
14,401 |
$584K |
| T4528 |
Adult size pull-on xl |
5,127 |
4,934 |
$582K |
| T4522 |
Adult size brief/diaper med |
6,540 |
6,226 |
$565K |
| A4554 |
Disposable underpads |
14,548 |
13,957 |
$543K |
| T4524 |
Adult size brief/diaper xl |
3,783 |
3,628 |
$447K |
| T4534 |
Youth size pull-on |
2,158 |
1,985 |
$315K |
| A4357 |
Bedside drainage bag |
4,520 |
3,793 |
$149K |
| T4543 |
Adult disp brief/diap abv xl |
756 |
682 |
$144K |
| A4553 |
Nondisp underpads, all sizes |
9,426 |
8,948 |
$143K |
| T5999 |
Supply, nos |
2,644 |
1,983 |
$128K |
| A4385 |
Ost skn barrier sld ext wear |
2,370 |
2,227 |
$121K |
| A4409 |
Ost skn barr convex <=4 sq i |
2,076 |
1,933 |
$116K |
| A4349 |
Disposable male external cat |
2,135 |
1,777 |
$96K |
| T4530 |
Ped size brief/diaper lg |
880 |
846 |
$90K |
| T4521 |
Adult size brief/diaper sm |
882 |
842 |
$89K |
| A4358 |
Urinary leg or abdomen bag |
3,725 |
3,061 |
$84K |
| A4407 |
Ext wear ost skn barr <=4sq" |
1,115 |
1,039 |
$76K |
| A4425 |
Ost pch drain for barrier fl |
1,448 |
1,365 |
$53K |
| T4533 |
Youth size brief/diaper |
400 |
392 |
$36K |
| T4537 |
Reusable underpad bed size |
1,867 |
1,840 |
$36K |
| A4335 |
Incontinence supply |
2,649 |
2,607 |
$35K |
| A9999 |
Dme supply or accessory, nos |
1,580 |
1,439 |
$32K |
| A4310 |
Insert tray w/o bag/cath |
470 |
427 |
$32K |
| A5063 |
Drain ostomy pouch w/flange |
801 |
766 |
$27K |
| A4362 |
Solid skin barrier |
844 |
789 |
$27K |
| A5120 |
Skin barrier, wipe or swab |
3,080 |
2,853 |
$23K |
| A4402 |
Lubricant per ounce |
2,609 |
2,312 |
$22K |
| A4217 |
Sterile water/saline, 500 ml |
1,052 |
944 |
$20K |
| A4456 |
Adhesive remover, wipes |
2,489 |
2,337 |
$19K |
| A4419 |
Ost pch for bar w flange/flt |
358 |
344 |
$18K |
| A4332 |
Lube sterile packet |
1,561 |
1,396 |
$17K |
| A4394 |
Ostomy pouch liq deodorant |
1,439 |
1,343 |
$17K |
| A6402 |
Sterile gauze <= 16 sq in |
1,327 |
1,173 |
$16K |
| A6250 |
Skin seal protect moisturizr |
1,450 |
1,445 |
$16K |
| A4520 |
Incontinence garment anytype |
273 |
255 |
$10K |
| A4322 |
Irrigation syringe |
737 |
623 |
$10K |
| T4525 |
Adult size pull-on sm |
66 |
65 |
$9K |
| A4371 |
Skin barrier powder per oz |
1,403 |
1,304 |
$7K |
| A4331 |
Extension drainage tubing |
360 |
342 |
$4K |
| A4406 |
Pectin based ostomy paste |
366 |
341 |
$3K |
| A4344 |
Cath indw foley 2 way silicn |
63 |
49 |
$3K |
| A4367 |
Ostomy belt |
543 |
500 |
$2K |
| A4320 |
Irrigation tray |
83 |
77 |
$2K |
| A4338 |
Indwelling catheter latex |
73 |
66 |
$2K |
| A6212 |
Foam drg <=16 sq in w/border |
14 |
13 |
$2K |
| A4455 |
Adhesive remover per ounce |
313 |
292 |
$2K |
| A4452 |
Waterproof tape |
111 |
104 |
$1K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
13 |
12 |
$380.16 |
| A4247 |
Betadine/iodine swabs/wipes |
50 |
49 |
$329.41 |
| A4245 |
Alcohol wipes per box |
114 |
111 |
$229.58 |
| T4540 |
Reusable underpad chair size |
12 |
12 |
$146.30 |
| A6216 |
Non-sterile gauze<=16 sq in |
12 |
12 |
$59.32 |
| A4314 |
Cath w/drainage 2-way latex |
13 |
12 |
$19.05 |