| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
6,776 |
6,064 |
$3.66M |
| T4541 |
Incontinence product, disposable underpad, large, each |
67,237 |
63,006 |
$2.52M |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
58,910 |
54,501 |
$2.39M |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
22,681 |
21,659 |
$2.08M |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
21,733 |
20,949 |
$2.01M |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
19,764 |
19,295 |
$1.61M |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12,439 |
11,879 |
$1.43M |
| A4927 |
Gloves, non-sterile, per 100 |
57,556 |
53,924 |
$1.09M |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
6,030 |
5,526 |
$1.01M |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
11,746 |
11,094 |
$974K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
9,235 |
8,950 |
$775K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
8,920 |
8,610 |
$753K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
5,391 |
4,691 |
$655K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
5,312 |
4,871 |
$494K |
| A4554 |
Disposable underpads, all sizes |
17,045 |
16,749 |
$452K |
| B4160 |
Enteral formula, for pediatrics, nutritionally complete calorically dense (equal to or greater than 0.7 kcal/ml) with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
1,928 |
1,791 |
$370K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,993 |
1,895 |
$234K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
2,882 |
2,761 |
$199K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
2,294 |
1,612 |
$156K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
722 |
671 |
$134K |
| T4529 |
Pediatric sized disposable incontinence product, brief/diaper, small/medium size, each |
632 |
621 |
$49K |
| A4217 |
Sterile water/saline, 500 ml |
284 |
264 |
$34K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
388 |
371 |
$28K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
92 |
88 |
$23K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
150 |
142 |
$17K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
3,416 |
2,592 |
$17K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
161 |
147 |
$14K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
240 |
210 |
$10K |
| A4322 |
Irrigation syringe, bulb or piston, each |
240 |
231 |
$7K |
| A4402 |
Lubricant, per ounce |
1,524 |
1,347 |
$6K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
2,418 |
1,690 |
$5K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,444 |
1,266 |
$5K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,031 |
903 |
$5K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
157 |
143 |
$4K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
93 |
84 |
$4K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
211 |
203 |
$2K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
65 |
63 |
$2K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
44 |
37 |
$1K |
| A4452 |
Tape, waterproof, per 18 square inches |
51 |
50 |
$1K |
| A4332 |
Lubricant, individual sterile packet, each |
14 |
13 |
$884.70 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
106 |
94 |
$715.48 |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
14 |
13 |
$713.09 |
| T5999 |
Supply, not otherwise specified |
63 |
63 |
$490.55 |
| A4371 |
Ostomy skin barrier, powder, per oz |
40 |
40 |
$88.01 |