| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
20,707 |
17,600 |
$13.01M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
20,096 |
16,925 |
$2.04M |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
4,108 |
3,500 |
$1.11M |
| T4541 |
Incontinence product, disposable underpad, large, each |
14,603 |
13,356 |
$600K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
13,052 |
11,210 |
$574K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
10,606 |
8,981 |
$554K |
| A4459 |
Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type |
532 |
382 |
$453K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
4,330 |
3,826 |
$330K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
3,466 |
3,006 |
$328K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
9,408 |
8,123 |
$322K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
4,749 |
3,971 |
$274K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
3,212 |
2,808 |
$209K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
2,969 |
2,674 |
$201K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
2,716 |
2,421 |
$200K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
4,721 |
4,178 |
$181K |
| A4927 |
Gloves, non-sterile, per 100 |
17,123 |
15,114 |
$163K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,893 |
1,713 |
$161K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
6,337 |
5,388 |
$152K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
1,760 |
1,478 |
$130K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
5,658 |
4,704 |
$120K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
2,454 |
2,089 |
$104K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
819 |
681 |
$101K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
1,819 |
1,613 |
$86K |
| E1399 |
Durable medical equipment, miscellaneous |
146 |
82 |
$86K |
| A4554 |
Disposable underpads, all sizes |
3,864 |
3,267 |
$85K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
8,893 |
7,598 |
$82K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
2,955 |
2,551 |
$80K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
8,284 |
7,108 |
$77K |
| A4456 |
Adhesive remover, wipes, any type, each |
12,573 |
10,964 |
$64K |
| A5120 |
Skin barrier, wipes or swabs, each |
13,967 |
12,132 |
$58K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
695 |
615 |
$57K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
1,697 |
1,444 |
$51K |
| A4388 |
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each |
1,728 |
1,360 |
$50K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
722 |
634 |
$48K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
1,131 |
998 |
$46K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
6,236 |
5,404 |
$46K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
6,642 |
5,652 |
$45K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
848 |
732 |
$35K |
| A4452 |
Tape, waterproof, per 18 square inches |
2,333 |
2,036 |
$32K |
| A4332 |
Lubricant, individual sterile packet, each |
3,651 |
3,140 |
$30K |
| A4217 |
Sterile water/saline, 500 ml |
1,905 |
1,701 |
$27K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
56 |
36 |
$27K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
308 |
247 |
$23K |
| A4430 |
Ostomy pouch, urinary, with extended wear barrier attached, with built-in convexity, with faucet-type tap with valve (1 piece), each |
253 |
213 |
$20K |
| A4371 |
Ostomy skin barrier, powder, per oz |
7,859 |
6,896 |
$20K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
306 |
279 |
$19K |
| A4402 |
Lubricant, per ounce |
4,457 |
3,871 |
$19K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
267 |
180 |
$19K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
487 |
417 |
$18K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
1,569 |
1,299 |
$18K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,019 |
1,800 |
$16K |
| A4389 |
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each |
259 |
226 |
$14K |
| A4322 |
Irrigation syringe, bulb or piston, each |
1,082 |
968 |
$13K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
330 |
305 |
$13K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
1,498 |
1,317 |
$11K |
| A4367 |
Ostomy belt, each |
3,132 |
2,787 |
$10K |
| A4410 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, larger than 4 x 4 inches, each |
135 |
105 |
$10K |
| A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
426 |
362 |
$10K |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
156 |
109 |
$10K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
957 |
800 |
$8K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
151 |
141 |
$6K |
| A4553 |
Non-disposable underpads, all sizes |
521 |
442 |
$6K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
243 |
178 |
$6K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
97 |
69 |
$5K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
785 |
698 |
$5K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
2,657 |
2,235 |
$5K |
| A4335 |
Incontinence supply; miscellaneous |
1,280 |
1,011 |
$4K |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
1,322 |
1,178 |
$3K |
| A4373 |
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each |
57 |
48 |
$3K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
836 |
746 |
$3K |
| A4390 |
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each |
26 |
24 |
$2K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
17 |
12 |
$2K |
| B4036 |
Enteral feeding supply kit; gravity fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
27 |
25 |
$1K |
| A4428 |
Ostomy pouch, urinary, with extended wear barrier attached, with faucet-type tap with valve (1 piece), each |
12 |
12 |
$645.38 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
161 |
149 |
$514.07 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
147 |
122 |
$503.24 |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
34 |
26 |
$478.17 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
12 |
12 |
$221.99 |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
68 |
51 |
$53.34 |