| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4554 |
Disposable underpads, all sizes |
50,389 |
46,300 |
$1.86M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
11,321 |
10,466 |
$1.16M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
9,898 |
9,126 |
$1.04M |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
8,779 |
8,040 |
$862K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
4,220 |
3,764 |
$764K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
6,870 |
6,400 |
$697K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
8,306 |
7,673 |
$654K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
2,535 |
2,311 |
$586K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
58,268 |
54,278 |
$575K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
4,659 |
4,271 |
$499K |
| A4927 |
Gloves, non-sterile, per 100 |
14,094 |
12,369 |
$407K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
13,511 |
11,894 |
$392K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
4,125 |
3,763 |
$328K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
2,973 |
2,624 |
$110K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
906 |
825 |
$65K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
4,181 |
3,727 |
$43K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
582 |
562 |
$34K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
3,913 |
3,502 |
$33K |
| A4456 |
Adhesive remover, wipes, any type, each |
653 |
618 |
$8K |
| A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
2,336 |
2,153 |
$7K |
| A4335 |
Incontinence supply; miscellaneous |
301 |
293 |
$6K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
647 |
625 |
$5K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
618 |
602 |
$5K |
| A4660 |
Sphygmomanometer/blood pressure apparatus with cuff and stethoscope |
140 |
137 |
$3K |
| A4244 |
Alcohol or peroxide, per pint |
493 |
477 |
$3K |
| A4402 |
Lubricant, per ounce |
58 |
50 |
$632.61 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
62 |
48 |
$376.26 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
14 |
12 |
$309.41 |
| A5120 |
Skin barrier, wipes or swabs, each |
25 |
25 |
$288.00 |
| A4245 |
Alcohol wipes, per box |
13 |
13 |
$29.50 |