| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
4,562 |
4,167 |
$161K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
5,483 |
4,915 |
$120K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
2,410 |
2,219 |
$105K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
3,532 |
3,269 |
$80K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
2,987 |
2,706 |
$52K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
3,649 |
3,241 |
$32K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
1,229 |
1,105 |
$30K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
2,161 |
1,951 |
$30K |
| A4456 |
Adhesive remover, wipes, any type, each |
5,692 |
5,136 |
$26K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
833 |
764 |
$18K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
523 |
505 |
$17K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
212 |
195 |
$16K |
| A5120 |
Skin barrier, wipes or swabs, each |
4,312 |
3,872 |
$16K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
26 |
24 |
$14K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
1,509 |
1,349 |
$10K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,571 |
1,408 |
$8K |
| A4371 |
Ostomy skin barrier, powder, per oz |
2,115 |
1,917 |
$7K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
248 |
167 |
$6K |
| A4367 |
Ostomy belt, each |
819 |
755 |
$4K |
| A4388 |
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each |
114 |
104 |
$3K |