| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
841 |
773 |
$330K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
3,166 |
2,890 |
$298K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
3,438 |
2,987 |
$163K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
2,130 |
1,924 |
$109K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
1,237 |
1,105 |
$32K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
1,330 |
1,161 |
$26K |
| A4408 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, with built-in convexity, larger than 4 x 4 inches, each |
389 |
329 |
$26K |
| K0001 |
Standard wheelchair |
1,795 |
1,553 |
$21K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
881 |
776 |
$17K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
1,697 |
1,496 |
$14K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
1,135 |
998 |
$13K |
| E0570 |
Nebulizer, with compressor |
922 |
790 |
$13K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,894 |
1,712 |
$10K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
246 |
225 |
$7K |
| E0601 |
Continuous positive airway pressure (cpap) device |
207 |
191 |
$6K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,527 |
1,266 |
$6K |
| K0003 |
Lightweight wheelchair |
171 |
145 |
$4K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
63 |
58 |
$4K |
| A4452 |
Tape, waterproof, per 18 square inches |
462 |
414 |
$3K |
| A4402 |
Lubricant, per ounce |
941 |
897 |
$3K |
| E0147 |
Walker, heavy duty, multiple braking system, variable wheel resistance |
15 |
14 |
$2K |
| A5120 |
Skin barrier, wipes or swabs, each |
325 |
301 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
45 |
36 |
$1K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
32 |
25 |
$673.95 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
17 |
14 |
$645.09 |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
13 |
12 |
$361.61 |
| A7035 |
Headgear used with positive airway pressure device |
21 |
17 |
$257.57 |
| A4371 |
Ostomy skin barrier, powder, per oz |
74 |
67 |
$194.36 |
| A4332 |
Lubricant, individual sterile packet, each |
24 |
24 |
$191.24 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
64 |
54 |
$178.57 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
28 |
24 |
$169.68 |