| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
1,766 |
1,331 |
$903K |
| A4351 |
Straight tip urine catheter |
9,073 |
6,611 |
$635K |
| A4385 |
Ost skn barrier sld ext wear |
7,105 |
5,235 |
$285K |
| A4409 |
Ost skn barr convex <=4 sq i |
5,207 |
3,785 |
$227K |
| A4352 |
Coude tip urinary catheter |
818 |
603 |
$175K |
| A4362 |
Solid skin barrier |
6,442 |
4,849 |
$173K |
| A4407 |
Ext wear ost skn barr <=4sq" |
2,112 |
1,590 |
$157K |
| A4425 |
Ost pch drain for barrier fl |
4,605 |
3,474 |
$135K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
2,833 |
2,073 |
$96K |
| A4394 |
Ostomy pouch liq deodorant |
5,129 |
3,774 |
$81K |
| A5063 |
Drain ostomy pouch w/flange |
3,058 |
2,217 |
$61K |
| A4456 |
Adhesive remover, wipes |
7,188 |
5,433 |
$37K |
| A4406 |
Pectin based ostomy paste |
3,420 |
2,567 |
$35K |
| A4432 |
Os pch urine w bar/fange/tap |
912 |
650 |
$25K |
| A4349 |
Disposable male external cat |
1,081 |
801 |
$22K |
| A4419 |
Ost pch for bar w flange/flt |
509 |
368 |
$18K |
| A5120 |
Skin barrier, wipe or swab |
5,079 |
3,755 |
$18K |
| A4357 |
Bedside drainage bag |
3,158 |
2,350 |
$17K |
| A4424 |
Ost pch drain w bar & filter |
216 |
147 |
$8K |
| A4371 |
Skin barrier powder per oz |
2,717 |
2,079 |
$6K |
| A4358 |
Urinary leg or abdomen bag |
2,067 |
1,528 |
$6K |
| A4452 |
Waterproof tape |
1,043 |
765 |
$6K |
| A4367 |
Ostomy belt |
1,667 |
1,264 |
$5K |
| A5057 |
1 pc ost pou w built-in conv |
52 |
38 |
$4K |
| A4332 |
Lube sterile packet |
1,040 |
737 |
$4K |
| A5056 |
1 pc ost pouch w filter |
59 |
51 |
$3K |
| A4427 |
Ost pch drain/barr lk flng/f |
50 |
37 |
$1K |
| A4338 |
Indwelling catheter latex |
168 |
132 |
$855.15 |
| A5061 |
Pouch drainable w barrier at |
19 |
15 |
$801.46 |
| A5055 |
Stoma cap |
36 |
28 |
$728.08 |
| A4389 |
Drainable pch w st wear barr |
13 |
12 |
$682.07 |
| A4310 |
Insert tray w/o bag/cath |
179 |
129 |
$501.29 |
| A6216 |
Non-sterile gauze<=16 sq in |
45 |
37 |
$61.27 |