| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
10,292 |
8,292 |
$5.11M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
14,342 |
11,566 |
$1.65M |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
3,114 |
2,428 |
$895K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
1,367 |
1,148 |
$419K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
890 |
774 |
$207K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,645 |
1,384 |
$202K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
1,993 |
1,640 |
$178K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
7,406 |
4,328 |
$114K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
2,381 |
1,944 |
$110K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
4,369 |
3,669 |
$106K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
1,949 |
702 |
$85K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
6,377 |
3,659 |
$80K |
| A4452 |
Tape, waterproof, per 18 square inches |
5,391 |
4,467 |
$70K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
2,713 |
1,482 |
$57K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
490 |
418 |
$57K |
| A6210 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
130 |
115 |
$52K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
320 |
275 |
$39K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
6,104 |
5,160 |
$32K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
1,164 |
838 |
$26K |
| A4402 |
Lubricant, per ounce |
6,335 |
5,293 |
$25K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
710 |
496 |
$18K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
500 |
424 |
$15K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
641 |
551 |
$12K |
| A4554 |
Disposable underpads, all sizes |
702 |
568 |
$10K |
| A4927 |
Gloves, non-sterile, per 100 |
767 |
631 |
$9K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
205 |
170 |
$9K |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
187 |
155 |
$9K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
168 |
156 |
$8K |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
1,190 |
994 |
$7K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
183 |
169 |
$6K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
221 |
204 |
$4K |
| A4332 |
Lubricant, individual sterile packet, each |
654 |
521 |
$4K |
| A4322 |
Irrigation syringe, bulb or piston, each |
415 |
311 |
$4K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
357 |
314 |
$4K |
| T4541 |
Incontinence product, disposable underpad, large, each |
260 |
226 |
$4K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
145 |
106 |
$4K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
100 |
90 |
$3K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
299 |
241 |
$3K |
| A4315 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone |
33 |
24 |
$1K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
30 |
24 |
$1K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
15 |
12 |
$994.75 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
284 |
233 |
$787.44 |
| A5120 |
Skin barrier, wipes or swabs, each |
126 |
106 |
$488.13 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
74 |
64 |
$389.02 |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
14 |
12 |
$251.88 |
| A6260 |
Wound cleansers, any type, any size |
357 |
304 |
$245.29 |
| A4217 |
Sterile water/saline, 500 ml |
22 |
21 |
$63.69 |