| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
6,776 |
6,064 |
$3.66M |
| T4541 |
Large disposable underpad |
67,237 |
63,006 |
$2.52M |
| T4535 |
Disposable liner/shield/pad |
58,910 |
54,501 |
$2.39M |
| T4527 |
Adult size pull-on lg |
22,681 |
21,659 |
$2.08M |
| T4526 |
Adult size pull-on med |
21,733 |
20,949 |
$2.01M |
| T4534 |
Youth size pull-on |
19,764 |
19,295 |
$1.61M |
| T4528 |
Adult size pull-on xl |
12,439 |
11,879 |
$1.43M |
| A4927 |
Non-sterile gloves |
57,556 |
53,924 |
$1.09M |
| T4544 |
Adlt disp und/pull on abv xl |
6,030 |
5,526 |
$1.01M |
| T4525 |
Adult size pull-on sm |
11,746 |
11,094 |
$974K |
| T4530 |
Ped size brief/diaper lg |
9,235 |
8,950 |
$775K |
| T4522 |
Adult size brief/diaper med |
8,920 |
8,610 |
$753K |
| A4351 |
Straight tip urine catheter |
5,391 |
4,691 |
$655K |
| T4523 |
Adult size brief/diaper lg |
5,312 |
4,871 |
$494K |
| A4554 |
Disposable underpads |
17,045 |
16,749 |
$452K |
| B4160 |
Ef ped caloric dense>/=0.7kc |
1,928 |
1,791 |
$370K |
| T4524 |
Adult size brief/diaper xl |
1,993 |
1,895 |
$234K |
| T4521 |
Adult size brief/diaper sm |
2,882 |
2,761 |
$199K |
| A4349 |
Disposable male external cat |
2,294 |
1,612 |
$156K |
| T4543 |
Adult disp brief/diap abv xl |
722 |
671 |
$134K |
| T4529 |
Ped size brief/diaper sm/med |
632 |
621 |
$49K |
| A4217 |
Sterile water/saline, 500 ml |
284 |
264 |
$34K |
| T4532 |
Ped size pull-on lg |
388 |
371 |
$28K |
| A6212 |
Foam drg <=16 sq in w/border |
92 |
88 |
$23K |
| A6446 |
Conform band s w>=3" <5"/yd |
150 |
142 |
$17K |
| A4357 |
Bedside drainage bag |
3,416 |
2,592 |
$17K |
| B4150 |
Ef complet w/intact nutrient |
161 |
147 |
$14K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
240 |
210 |
$10K |
| A4322 |
Irrigation syringe |
240 |
231 |
$7K |
| A4402 |
Lubricant per ounce |
1,524 |
1,347 |
$6K |
| A4358 |
Urinary leg or abdomen bag |
2,418 |
1,690 |
$5K |
| A5120 |
Skin barrier, wipe or swab |
1,444 |
1,266 |
$5K |
| A4456 |
Adhesive remover, wipes |
1,031 |
903 |
$5K |
| A4385 |
Ost skn barrier sld ext wear |
157 |
143 |
$4K |
| A4425 |
Ost pch drain for barrier fl |
93 |
84 |
$4K |
| A6402 |
Sterile gauze <= 16 sq in |
211 |
203 |
$2K |
| A5063 |
Drain ostomy pouch w/flange |
65 |
63 |
$2K |
| A4362 |
Solid skin barrier |
44 |
37 |
$1K |
| A4452 |
Waterproof tape |
51 |
50 |
$1K |
| A4332 |
Lube sterile packet |
14 |
13 |
$884.70 |
| A4406 |
Pectin based ostomy paste |
106 |
94 |
$715.48 |
| A4409 |
Ost skn barr convex <=4 sq i |
14 |
13 |
$713.09 |
| T5999 |
Supply, nos |
63 |
63 |
$490.55 |
| A4371 |
Skin barrier powder per oz |
40 |
40 |
$88.01 |