| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
841 |
773 |
$330K |
| A4351 |
Straight tip urine catheter |
3,166 |
2,890 |
$298K |
| A4385 |
Ost skn barrier sld ext wear |
3,438 |
2,987 |
$163K |
| A4409 |
Ost skn barr convex <=4 sq i |
2,130 |
1,924 |
$109K |
| A4425 |
Ost pch drain for barrier fl |
1,237 |
1,105 |
$32K |
| A5063 |
Drain ostomy pouch w/flange |
1,330 |
1,161 |
$26K |
| A4408 |
Ext wear ost skn barr >4sq" |
389 |
329 |
$26K |
| K0001 |
Standard wheelchair |
1,795 |
1,553 |
$21K |
| E0260 |
Hosp bed semi-electr w/ matt |
881 |
776 |
$17K |
| A4406 |
Pectin based ostomy paste |
1,697 |
1,496 |
$14K |
| A4394 |
Ostomy pouch liq deodorant |
1,135 |
998 |
$13K |
| E0570 |
Nebulizer with compression |
922 |
790 |
$13K |
| A4456 |
Adhesive remover, wipes |
1,894 |
1,712 |
$10K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
246 |
225 |
$7K |
| E0601 |
Cont airway pressure device |
207 |
191 |
$6K |
| A4357 |
Bedside drainage bag |
1,527 |
1,266 |
$6K |
| K0003 |
Lightweight wheelchair |
171 |
145 |
$4K |
| E0562 |
Humidifier heated used w pap |
63 |
58 |
$4K |
| A4452 |
Waterproof tape |
462 |
414 |
$3K |
| A4402 |
Lubricant per ounce |
941 |
897 |
$3K |
| E0147 |
Walker variable wheel resist |
15 |
14 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
325 |
301 |
$1K |
| A4604 |
Tubing with heating element |
45 |
36 |
$1K |
| A4349 |
Disposable male external cat |
32 |
25 |
$673.95 |
| A7034 |
Nasal application device |
17 |
14 |
$645.09 |
| A4432 |
Os pch urine w bar/fange/tap |
13 |
12 |
$361.61 |
| A7035 |
Pos airway press headgear |
21 |
17 |
$257.57 |
| A4371 |
Skin barrier powder per oz |
74 |
67 |
$194.36 |
| A4332 |
Lube sterile packet |
24 |
24 |
$191.24 |
| A7038 |
Pos airway pressure filter |
64 |
54 |
$178.57 |
| A7005 |
Nondisposable nebulizer set |
28 |
24 |
$169.68 |