| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
4,470 |
4,146 |
$2.04M |
| A4351 |
Straight tip urine catheter |
7,233 |
6,794 |
$410K |
| A4352 |
Coude tip urinary catheter |
1,423 |
1,329 |
$163K |
| A4385 |
Ost skn barrier sld ext wear |
2,899 |
2,777 |
$139K |
| A4409 |
Ost skn barr convex <=4 sq i |
2,643 |
2,515 |
$134K |
| A4407 |
Ext wear ost skn barr <=4sq" |
1,340 |
1,256 |
$91K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
2,421 |
2,285 |
$87K |
| A4425 |
Ost pch drain for barrier fl |
2,703 |
2,522 |
$66K |
| A5063 |
Drain ostomy pouch w/flange |
2,409 |
2,297 |
$59K |
| A4362 |
Solid skin barrier |
2,077 |
1,972 |
$41K |
| A4357 |
Bedside drainage bag |
1,820 |
1,652 |
$32K |
| A4419 |
Ost pch for bar w flange/flt |
834 |
780 |
$31K |
| A4394 |
Ostomy pouch liq deodorant |
1,769 |
1,680 |
$29K |
| A4456 |
Adhesive remover, wipes |
6,291 |
5,990 |
$24K |
| A4927 |
Non-sterile gloves |
2,002 |
1,781 |
$22K |
| T4535 |
Disposable liner/shield/pad |
632 |
567 |
$22K |
| A5120 |
Skin barrier, wipe or swab |
6,143 |
5,865 |
$21K |
| T4526 |
Adult size pull-on med |
375 |
339 |
$21K |
| T4527 |
Adult size pull-on lg |
357 |
314 |
$20K |
| T4528 |
Adult size pull-on xl |
287 |
241 |
$19K |
| T4537 |
Reusable underpad bed size |
517 |
430 |
$14K |
| A4424 |
Ost pch drain w bar & filter |
165 |
152 |
$13K |
| A4554 |
Disposable underpads |
1,216 |
1,032 |
$9K |
| A5061 |
Pouch drainable w barrier at |
340 |
322 |
$8K |
| T4541 |
Large disposable underpad |
501 |
451 |
$8K |
| A4332 |
Lube sterile packet |
4,003 |
3,762 |
$7K |
| A4406 |
Pectin based ostomy paste |
1,405 |
1,333 |
$7K |
| A4371 |
Skin barrier powder per oz |
2,256 |
2,173 |
$4K |
| A5056 |
1 pc ost pouch w filter |
94 |
88 |
$4K |
| A4367 |
Ostomy belt |
1,123 |
1,076 |
$3K |
| A4358 |
Urinary leg or abdomen bag |
599 |
519 |
$3K |
| A4335 |
Incontinence supply |
199 |
143 |
$3K |
| T4544 |
Adlt disp und/pull on abv xl |
15 |
12 |
$2K |
| A4402 |
Lubricant per ounce |
375 |
351 |
$2K |
| A4432 |
Os pch urine w bar/fange/tap |
97 |
89 |
$2K |
| T4523 |
Adult size brief/diaper lg |
30 |
25 |
$2K |
| A4452 |
Waterproof tape |
132 |
105 |
$1K |
| A4369 |
Skin barrier liquid per oz |
579 |
541 |
$938.19 |
| A4389 |
Drainable pch w st wear barr |
12 |
12 |
$578.92 |
| A4455 |
Adhesive remover per ounce |
595 |
561 |
$479.46 |
| A4553 |
Nondisp underpads, all sizes |
14 |
13 |
$218.88 |
| A4349 |
Disposable male external cat |
15 |
12 |
$109.83 |
| A4217 |
Sterile water/saline, 500 ml |
17 |
12 |
$74.18 |
| A4405 |
Nonpectin based ostomy paste |
16 |
14 |
$73.53 |