| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
2,833 |
1,985 |
$2.44M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,293 |
919 |
$180K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
663 |
485 |
$38K |
| A4554 |
Disposable underpads, all sizes |
1,247 |
889 |
$30K |
| A4453 |
Rectal catheter with or without balloon, for use with any type transanal irrigation system, each |
23 |
12 |
$15K |
| A4322 |
Irrigation syringe, bulb or piston, each |
659 |
569 |
$10K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
755 |
592 |
$10K |
| T5999 |
Supply, not otherwise specified |
901 |
575 |
$10K |
| A4332 |
Lubricant, individual sterile packet, each |
1,413 |
1,066 |
$9K |
| A4927 |
Gloves, non-sterile, per 100 |
778 |
513 |
$7K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
172 |
131 |
$6K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
43 |
40 |
$4K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
66 |
51 |
$3K |
| A5120 |
Skin barrier, wipes or swabs, each |
210 |
171 |
$2K |
| A4458 |
Enema bag with tubing, reusable |
538 |
432 |
$1K |
| A4371 |
Ostomy skin barrier, powder, per oz |
282 |
223 |
$559.43 |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
46 |
26 |
$526.29 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
33 |
24 |
$359.37 |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
15 |
12 |
$261.42 |
| A4456 |
Adhesive remover, wipes, any type, each |
45 |
36 |
$237.12 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
17 |
12 |
$96.52 |
| A4367 |
Ostomy belt, each |
15 |
12 |
$55.68 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
32 |
25 |
$0.00 |