| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
3,429 |
2,995 |
$1.93M |
| T4534 |
Youth size pull-on |
1,469 |
1,408 |
$154K |
| A4351 |
Straight tip urine catheter |
1,463 |
1,111 |
$149K |
| A4554 |
Disposable underpads |
2,451 |
2,337 |
$121K |
| A5120 |
Skin barrier, wipe or swab |
1,518 |
1,445 |
$56K |
| T4530 |
Ped size brief/diaper lg |
650 |
578 |
$56K |
| A4349 |
Disposable male external cat |
959 |
779 |
$47K |
| T4532 |
Ped size pull-on lg |
411 |
401 |
$44K |
| A4357 |
Bedside drainage bag |
1,128 |
915 |
$43K |
| A4927 |
Non-sterile gloves |
1,684 |
1,559 |
$40K |
| T4526 |
Adult size pull-on med |
465 |
439 |
$38K |
| T4522 |
Adult size brief/diaper med |
305 |
292 |
$23K |
| T4521 |
Adult size brief/diaper sm |
381 |
346 |
$23K |
| T4525 |
Adult size pull-on sm |
143 |
132 |
$16K |
| A4332 |
Lube sterile packet |
420 |
324 |
$15K |
| T4523 |
Adult size brief/diaper lg |
98 |
96 |
$14K |
| T4527 |
Adult size pull-on lg |
193 |
184 |
$12K |
| A4245 |
Alcohol wipes per box |
546 |
534 |
$8K |
| A4358 |
Urinary leg or abdomen bag |
1,120 |
721 |
$6K |
| T4535 |
Disposable liner/shield/pad |
102 |
80 |
$3K |
| A4402 |
Lubricant per ounce |
116 |
88 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
47 |
39 |
$2K |
| A9900 |
Supply/accessory/service |
26 |
13 |
$1K |