| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
7,320 |
5,693 |
$5.06M |
| A4351 |
Straight tip urine catheter |
10,216 |
7,745 |
$1.41M |
| A4352 |
Coude tip urinary catheter |
1,018 |
726 |
$492K |
| A4409 |
Ost skn barr convex <=4 sq i |
5,292 |
4,025 |
$396K |
| A4385 |
Ost skn barrier sld ext wear |
5,273 |
3,849 |
$317K |
| A9270 |
Non-covered item or service |
240 |
135 |
$189K |
| A4407 |
Ext wear ost skn barr <=4sq" |
2,018 |
1,458 |
$182K |
| E1399 |
Durable medical equipment mi |
222 |
94 |
$179K |
| A4554 |
Disposable underpads |
5,071 |
3,539 |
$163K |
| A4425 |
Ost pch drain for barrier fl |
3,300 |
2,538 |
$138K |
| A5063 |
Drain ostomy pouch w/flange |
3,518 |
2,607 |
$120K |
| A4362 |
Solid skin barrier |
2,725 |
1,929 |
$98K |
| A4349 |
Disposable male external cat |
1,988 |
1,488 |
$74K |
| T4526 |
Adult size pull-on med |
1,440 |
1,031 |
$64K |
| A4927 |
Non-sterile gloves |
6,105 |
4,574 |
$58K |
| A4357 |
Bedside drainage bag |
5,300 |
4,099 |
$54K |
| A4394 |
Ostomy pouch liq deodorant |
3,797 |
2,804 |
$47K |
| T4534 |
Youth size pull-on |
810 |
546 |
$36K |
| T4527 |
Adult size pull-on lg |
604 |
422 |
$31K |
| A5120 |
Skin barrier, wipe or swab |
5,833 |
4,275 |
$28K |
| A4456 |
Adhesive remover, wipes |
4,303 |
3,105 |
$26K |
| A4406 |
Pectin based ostomy paste |
2,771 |
2,103 |
$26K |
| A4358 |
Urinary leg or abdomen bag |
3,778 |
2,861 |
$24K |
| T5999 |
Supply, nos |
3,101 |
2,111 |
$22K |
| A4332 |
Lube sterile packet |
2,245 |
1,669 |
$19K |
| A4459 |
Transanal irrigation, any |
210 |
131 |
$18K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
252 |
193 |
$16K |
| A4432 |
Os pch urine w bar/fange/tap |
340 |
268 |
$15K |
| A4371 |
Skin barrier powder per oz |
3,950 |
2,848 |
$14K |
| A4217 |
Sterile water/saline, 500 ml |
815 |
605 |
$10K |
| A4338 |
Indwelling catheter latex |
932 |
775 |
$10K |
| A4402 |
Lubricant per ounce |
2,327 |
1,614 |
$8K |
| T4535 |
Disposable liner/shield/pad |
373 |
244 |
$5K |
| A4310 |
Insert tray w/o bag/cath |
408 |
357 |
$3K |
| A4367 |
Ostomy belt |
1,044 |
708 |
$3K |
| A4335 |
Incontinence supply |
596 |
459 |
$3K |
| A4452 |
Waterproof tape |
152 |
112 |
$2K |
| A4364 |
Adhesive, liquid or equal |
202 |
151 |
$2K |
| B4036 |
Enteral feed sup kit grav by |
103 |
88 |
$1K |
| A6216 |
Non-sterile gauze<=16 sq in |
388 |
232 |
$1K |
| A4322 |
Irrigation syringe |
131 |
101 |
$1K |
| A5056 |
1 pc ost pouch w filter |
18 |
12 |
$708.35 |
| A4419 |
Ost pch for bar w flange/flt |
18 |
13 |
$696.88 |
| A4455 |
Adhesive remover per ounce |
40 |
27 |
$154.26 |
| A4213 |
20+ cc syringe only |
15 |
12 |
$42.78 |
| W4047 |
|
14 |
13 |
$0.00 |