| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
6,464 |
5,531 |
$4.56M |
| A4351 |
Straight tip urine catheter |
4,142 |
3,664 |
$403K |
| A4352 |
Coude tip urinary catheter |
888 |
732 |
$250K |
| A4385 |
Ost skn barrier sld ext wear |
992 |
877 |
$62K |
| A4554 |
Disposable underpads |
1,662 |
1,443 |
$57K |
| A4407 |
Ext wear ost skn barr <=4sq" |
518 |
489 |
$56K |
| A4409 |
Ost skn barr convex <=4 sq i |
569 |
495 |
$33K |
| A4425 |
Ost pch drain for barrier fl |
731 |
664 |
$30K |
| A4362 |
Solid skin barrier |
717 |
627 |
$29K |
| A4349 |
Disposable male external cat |
645 |
547 |
$27K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
524 |
451 |
$27K |
| A4357 |
Bedside drainage bag |
1,659 |
1,490 |
$26K |
| A4927 |
Non-sterile gloves |
1,489 |
1,299 |
$20K |
| T4526 |
Adult size pull-on med |
214 |
184 |
$17K |
| A5063 |
Drain ostomy pouch w/flange |
459 |
409 |
$15K |
| A4394 |
Ostomy pouch liq deodorant |
634 |
555 |
$11K |
| A4358 |
Urinary leg or abdomen bag |
1,007 |
896 |
$10K |
| A4344 |
Cath indw foley 2 way silicn |
220 |
201 |
$10K |
| A5120 |
Skin barrier, wipe or swab |
1,656 |
1,424 |
$8K |
| A4456 |
Adhesive remover, wipes |
1,393 |
1,212 |
$8K |
| A4406 |
Pectin based ostomy paste |
605 |
535 |
$7K |
| A4213 |
20+ cc syringe only |
266 |
236 |
$5K |
| A4310 |
Insert tray w/o bag/cath |
240 |
211 |
$4K |
| A4402 |
Lubricant per ounce |
1,046 |
907 |
$4K |
| A4371 |
Skin barrier powder per oz |
778 |
677 |
$3K |
| A4432 |
Os pch urine w bar/fange/tap |
95 |
76 |
$3K |
| A4332 |
Lube sterile packet |
815 |
746 |
$2K |
| T4527 |
Adult size pull-on lg |
15 |
13 |
$1K |
| A4367 |
Ostomy belt |
189 |
173 |
$799.68 |
| A5061 |
Pouch drainable w barrier at |
18 |
13 |
$632.16 |
| A4217 |
Sterile water/saline, 500 ml |
15 |
13 |
$568.84 |
| A4452 |
Waterproof tape |
28 |
27 |
$386.99 |
| A4338 |
Indwelling catheter latex |
39 |
38 |
$266.96 |
| A4455 |
Adhesive remover per ounce |
26 |
24 |
$69.29 |
| A4369 |
Skin barrier liquid per oz |
14 |
13 |
$33.37 |