| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
2,126 |
1,578 |
$1.54M |
| A4453 |
Rectal catheter with or without balloon, for use with any type transanal irrigation system, each |
754 |
402 |
$510K |
| A4554 |
Disposable underpads, all sizes |
7,469 |
5,970 |
$331K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
2,251 |
1,814 |
$242K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,817 |
1,427 |
$236K |
| A4927 |
Gloves, non-sterile, per 100 |
6,763 |
5,342 |
$163K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,306 |
1,087 |
$145K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,107 |
869 |
$115K |
| A4459 |
Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type |
991 |
550 |
$106K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,516 |
1,181 |
$97K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
1,133 |
863 |
$82K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
773 |
572 |
$71K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
589 |
464 |
$60K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
1,123 |
926 |
$52K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
439 |
382 |
$40K |
| A9270 |
Non-covered item or service |
25 |
12 |
$23K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
486 |
363 |
$19K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
1,347 |
1,059 |
$16K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
879 |
705 |
$12K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
340 |
244 |
$12K |
| A4670 |
Automatic blood pressure monitor |
216 |
176 |
$11K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
711 |
500 |
$11K |
| A4335 |
Incontinence supply; miscellaneous |
1,350 |
1,117 |
$10K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,580 |
1,263 |
$9K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,859 |
1,433 |
$8K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
80 |
76 |
$7K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
75 |
65 |
$6K |
| A4371 |
Ostomy skin barrier, powder, per oz |
894 |
727 |
$5K |
| A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
82 |
79 |
$2K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
14 |
12 |
$2K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
138 |
119 |
$514.04 |
| A4367 |
Ostomy belt, each |
28 |
26 |
$58.09 |