| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
20,707 |
17,600 |
$13.01M |
| A4351 |
Straight tip urine catheter |
20,096 |
16,925 |
$2.04M |
| A4352 |
Coude tip urinary catheter |
4,108 |
3,500 |
$1.11M |
| T4541 |
Large disposable underpad |
14,603 |
13,356 |
$600K |
| A4385 |
Ost skn barrier sld ext wear |
13,052 |
11,210 |
$574K |
| A4409 |
Ost skn barr convex <=4 sq i |
10,606 |
8,981 |
$554K |
| A4459 |
Transanal irrigation, any |
532 |
382 |
$453K |
| T4526 |
Adult size pull-on med |
4,330 |
3,826 |
$330K |
| T4534 |
Youth size pull-on |
3,466 |
3,006 |
$328K |
| A4425 |
Ost pch drain for barrier fl |
9,408 |
8,123 |
$322K |
| A4407 |
Ext wear ost skn barr <=4sq" |
4,749 |
3,971 |
$274K |
| T4527 |
Adult size pull-on lg |
3,212 |
2,808 |
$209K |
| T4522 |
Adult size brief/diaper med |
2,969 |
2,674 |
$201K |
| T4523 |
Adult size brief/diaper lg |
2,716 |
2,421 |
$200K |
| T4535 |
Disposable liner/shield/pad |
4,721 |
4,178 |
$181K |
| A4927 |
Non-sterile gloves |
17,123 |
15,114 |
$163K |
| T4528 |
Adult size pull-on xl |
1,893 |
1,713 |
$161K |
| A4362 |
Solid skin barrier |
6,337 |
5,388 |
$152K |
| A5057 |
1 pc ost pou w built-in conv |
1,760 |
1,478 |
$130K |
| A5063 |
Drain ostomy pouch w/flange |
5,658 |
4,704 |
$120K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
2,454 |
2,089 |
$104K |
| T4543 |
Adult disp brief/diap abv xl |
819 |
681 |
$101K |
| A5056 |
1 pc ost pouch w filter |
1,819 |
1,613 |
$86K |
| E1399 |
Durable medical equipment mi |
146 |
82 |
$86K |
| A4554 |
Disposable underpads |
3,864 |
3,267 |
$85K |
| A4357 |
Bedside drainage bag |
8,893 |
7,598 |
$82K |
| A4349 |
Disposable male external cat |
2,955 |
2,551 |
$80K |
| A4394 |
Ostomy pouch liq deodorant |
8,284 |
7,108 |
$77K |
| A4456 |
Adhesive remover, wipes |
12,573 |
10,964 |
$64K |
| A5120 |
Skin barrier, wipe or swab |
13,967 |
12,132 |
$58K |
| T4524 |
Adult size brief/diaper xl |
695 |
615 |
$57K |
| A4432 |
Os pch urine w bar/fange/tap |
1,697 |
1,444 |
$51K |
| A4388 |
Drainable pch w ex wear barr |
1,728 |
1,360 |
$50K |
| T4530 |
Ped size brief/diaper lg |
722 |
634 |
$48K |
| A4419 |
Ost pch for bar w flange/flt |
1,131 |
998 |
$46K |
| A4406 |
Pectin based ostomy paste |
6,236 |
5,404 |
$46K |
| A4358 |
Urinary leg or abdomen bag |
6,642 |
5,652 |
$45K |
| A4424 |
Ost pch drain w bar & filter |
848 |
732 |
$35K |
| A4452 |
Waterproof tape |
2,333 |
2,036 |
$32K |
| A4332 |
Lube sterile packet |
3,651 |
3,140 |
$30K |
| A4217 |
Sterile water/saline, 500 ml |
1,905 |
1,701 |
$27K |
| A9999 |
Dme supply or accessory, nos |
56 |
36 |
$27K |
| T4525 |
Adult size pull-on sm |
308 |
247 |
$23K |
| A4430 |
Ost urine pch w b/bltin conv |
253 |
213 |
$20K |
| A4371 |
Skin barrier powder per oz |
7,859 |
6,896 |
$20K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
306 |
279 |
$19K |
| A4402 |
Lubricant per ounce |
4,457 |
3,871 |
$19K |
| T4532 |
Ped size pull-on lg |
267 |
180 |
$19K |
| A5121 |
Solid skin barrier 6x6 |
487 |
417 |
$18K |
| A4310 |
Insert tray w/o bag/cath |
1,569 |
1,299 |
$18K |
| A6402 |
Sterile gauze <= 16 sq in |
2,019 |
1,800 |
$16K |
| A4389 |
Drainable pch w st wear barr |
259 |
226 |
$14K |
| A4322 |
Irrigation syringe |
1,082 |
968 |
$13K |
| A4520 |
Incontinence garment anytype |
330 |
305 |
$13K |
| A4338 |
Indwelling catheter latex |
1,498 |
1,317 |
$11K |
| A4367 |
Ostomy belt |
3,132 |
2,787 |
$10K |
| A4410 |
Ost skn barr extnd >4 sq |
135 |
105 |
$10K |
| A4427 |
Ost pch drain/barr lk flng/f |
426 |
362 |
$10K |
| A4344 |
Cath indw foley 2 way silicn |
156 |
109 |
$10K |
| A4314 |
Cath w/drainage 2-way latex |
957 |
800 |
$8K |
| A5061 |
Pouch drainable w barrier at |
151 |
141 |
$6K |
| A4553 |
Nondisp underpads, all sizes |
521 |
442 |
$6K |
| T4537 |
Reusable underpad bed size |
243 |
178 |
$6K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
97 |
69 |
$5K |
| A4364 |
Adhesive, liquid or equal |
785 |
698 |
$5K |
| A4455 |
Adhesive remover per ounce |
2,657 |
2,235 |
$5K |
| A4335 |
Incontinence supply |
1,280 |
1,011 |
$4K |
| A4369 |
Skin barrier liquid per oz |
1,322 |
1,178 |
$3K |
| A4373 |
Skin barrier with flange |
57 |
48 |
$3K |
| A6216 |
Non-sterile gauze<=16 sq in |
836 |
746 |
$3K |
| A4390 |
Drainable pch ex wear convex |
26 |
24 |
$2K |
| T4533 |
Youth size brief/diaper |
17 |
12 |
$2K |
| B4036 |
Enteral feed sup kit grav by |
27 |
25 |
$1K |
| A4428 |
Urine ost pouch w faucet/tap |
12 |
12 |
$645.38 |
| A4450 |
Non-waterproof tape |
161 |
149 |
$514.07 |
| A4333 |
Urinary cath anchor device |
147 |
122 |
$503.24 |
| A4320 |
Irrigation tray |
34 |
26 |
$478.17 |
| A6446 |
Conform band s w>=3" <5"/yd |
12 |
12 |
$221.99 |
| A4334 |
Urinary cath leg strap |
68 |
51 |
$53.34 |