| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
1,766 |
1,331 |
$903K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
9,073 |
6,611 |
$635K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
7,105 |
5,235 |
$285K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
5,207 |
3,785 |
$227K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
818 |
603 |
$175K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
6,442 |
4,849 |
$173K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
2,112 |
1,590 |
$157K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
4,605 |
3,474 |
$135K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
2,833 |
2,073 |
$96K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
5,129 |
3,774 |
$81K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
3,058 |
2,217 |
$61K |
| A4456 |
Adhesive remover, wipes, any type, each |
7,188 |
5,433 |
$37K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
3,420 |
2,567 |
$35K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
912 |
650 |
$25K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
1,081 |
801 |
$22K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
509 |
368 |
$18K |
| A5120 |
Skin barrier, wipes or swabs, each |
5,079 |
3,755 |
$18K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
3,158 |
2,350 |
$17K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
216 |
147 |
$8K |
| A4371 |
Ostomy skin barrier, powder, per oz |
2,717 |
2,079 |
$6K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
2,067 |
1,528 |
$6K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,043 |
765 |
$6K |
| A4367 |
Ostomy belt, each |
1,667 |
1,264 |
$5K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
52 |
38 |
$4K |
| A4332 |
Lubricant, individual sterile packet, each |
1,040 |
737 |
$4K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
59 |
51 |
$3K |
| A4427 |
Ostomy pouch, drainable; for use on barrier with locking flange, with filter (2 piece system), each |
50 |
37 |
$1K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
168 |
132 |
$855.15 |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
19 |
15 |
$801.46 |
| A5055 |
Stoma cap |
36 |
28 |
$728.08 |
| A4389 |
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each |
13 |
12 |
$682.07 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
179 |
129 |
$501.29 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
45 |
37 |
$61.27 |