| Code | Description | Claims | Beneficiaries | Total Paid |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
7,320 |
5,693 |
$5.06M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
10,216 |
7,745 |
$1.41M |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
1,018 |
726 |
$492K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
5,292 |
4,025 |
$396K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
5,273 |
3,849 |
$317K |
| A9270 |
Non-covered item or service |
240 |
135 |
$189K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
2,018 |
1,458 |
$182K |
| E1399 |
Durable medical equipment, miscellaneous |
222 |
94 |
$179K |
| A4554 |
Disposable underpads, all sizes |
5,071 |
3,539 |
$163K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
3,300 |
2,538 |
$138K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
3,518 |
2,607 |
$120K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
2,725 |
1,929 |
$98K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
1,988 |
1,488 |
$74K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,440 |
1,031 |
$64K |
| A4927 |
Gloves, non-sterile, per 100 |
6,105 |
4,574 |
$58K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
5,300 |
4,099 |
$54K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
3,797 |
2,804 |
$47K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
810 |
546 |
$36K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
604 |
422 |
$31K |
| A5120 |
Skin barrier, wipes or swabs, each |
5,833 |
4,275 |
$28K |
| A4456 |
Adhesive remover, wipes, any type, each |
4,303 |
3,105 |
$26K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
2,771 |
2,103 |
$26K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
3,778 |
2,861 |
$24K |
| T5999 |
Supply, not otherwise specified |
3,101 |
2,111 |
$22K |
| A4332 |
Lubricant, individual sterile packet, each |
2,245 |
1,669 |
$19K |
| A4459 |
Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type |
210 |
131 |
$18K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
252 |
193 |
$16K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
340 |
268 |
$15K |
| A4371 |
Ostomy skin barrier, powder, per oz |
3,950 |
2,848 |
$14K |
| A4217 |
Sterile water/saline, 500 ml |
815 |
605 |
$10K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
932 |
775 |
$10K |
| A4402 |
Lubricant, per ounce |
2,327 |
1,614 |
$8K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
373 |
244 |
$5K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
408 |
357 |
$3K |
| A4367 |
Ostomy belt, each |
1,044 |
708 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
596 |
459 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
152 |
112 |
$2K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
202 |
151 |
$2K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
103 |
88 |
$1K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
388 |
232 |
$1K |
| A4322 |
Irrigation syringe, bulb or piston, each |
131 |
101 |
$1K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
18 |
12 |
$708.35 |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
18 |
13 |
$696.88 |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
40 |
27 |
$154.26 |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
15 |
12 |
$42.78 |
| W4047 |
|
14 |
13 |
$0.00 |