| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
13,363 |
12,331 |
$932K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
9,912 |
9,240 |
$728K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,449 |
2,259 |
$333K |
| A4927 |
Gloves, non-sterile, per 100 |
13,996 |
12,622 |
$247K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
1,880 |
1,711 |
$237K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,194 |
1,103 |
$187K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
1,529 |
1,337 |
$179K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,328 |
1,223 |
$179K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
1,299 |
1,235 |
$137K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
810 |
751 |
$111K |
| A9286 |
Hygienic item or device, disposable or non-disposable, any type, each |
1,356 |
1,200 |
$81K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
782 |
512 |
$67K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
463 |
419 |
$61K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
198 |
180 |
$46K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
53 |
49 |
$12K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,701 |
1,398 |
$12K |
| A4217 |
Sterile water/saline, 500 ml |
1,715 |
1,265 |
$9K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,413 |
1,144 |
$8K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
1,731 |
1,648 |
$7K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,297 |
926 |
$6K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
596 |
481 |
$5K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
605 |
442 |
$4K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
69 |
61 |
$4K |
| A4377 |
Ostomy pouch, drainable, for use on faceplate, plastic, each |
88 |
74 |
$4K |
| A4384 |
Ostomy faceplate equivalent, silicone ring, each |
14 |
12 |
$1K |
| A4456 |
Adhesive remover, wipes, any type, each |
179 |
157 |
$1K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
45 |
38 |
$1K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
260 |
187 |
$943.57 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
33 |
24 |
$927.50 |
| A4402 |
Lubricant, per ounce |
196 |
175 |
$452.96 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
34 |
24 |
$134.85 |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
27 |
24 |
$128.27 |