| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Straight tip urine catheter |
15,003 |
13,700 |
$4.98M |
| T5999 |
Supply, nos |
1,518 |
1,109 |
$621K |
| T4541 |
Large disposable underpad |
13,554 |
13,350 |
$591K |
| T4523 |
Adult size brief/diaper lg |
3,702 |
3,667 |
$334K |
| A4352 |
Coude tip urinary catheter |
731 |
713 |
$268K |
| T4534 |
Youth size pull-on |
1,318 |
1,311 |
$207K |
| A4344 |
Cath indw foley 2 way silicn |
325 |
320 |
$139K |
| T4526 |
Adult size pull-on med |
2,728 |
2,695 |
$136K |
| A4310 |
Insert tray w/o bag/cath |
575 |
561 |
$130K |
| T4522 |
Adult size brief/diaper med |
1,695 |
1,680 |
$127K |
| T4535 |
Disposable liner/shield/pad |
3,501 |
3,276 |
$121K |
| T4524 |
Adult size brief/diaper xl |
1,260 |
1,256 |
$118K |
| A4322 |
Irrigation syringe |
2,004 |
1,971 |
$107K |
| T4530 |
Ped size brief/diaper lg |
1,030 |
1,019 |
$101K |
| A4927 |
Non-sterile gloves |
7,829 |
7,414 |
$92K |
| A4385 |
Ost skn barrier sld ext wear |
1,182 |
1,130 |
$90K |
| A4357 |
Bedside drainage bag |
3,962 |
3,231 |
$83K |
| T4527 |
Adult size pull-on lg |
1,253 |
1,233 |
$76K |
| A4409 |
Ost skn barr convex <=4 sq i |
1,000 |
876 |
$75K |
| A4425 |
Ost pch drain for barrier fl |
1,025 |
981 |
$44K |
| A4353 |
Intermittent urinary cath |
93 |
87 |
$42K |
| T4528 |
Adult size pull-on xl |
509 |
498 |
$30K |
| A4358 |
Urinary leg or abdomen bag |
2,955 |
2,328 |
$30K |
| A4407 |
Ext wear ost skn barr <=4sq" |
313 |
284 |
$28K |
| A4349 |
Disposable male external cat |
1,002 |
909 |
$26K |
| A4332 |
Lube sterile packet |
2,466 |
2,412 |
$18K |
| A4402 |
Lubricant per ounce |
3,946 |
3,359 |
$15K |
| A4314 |
Cath w/drainage 2-way latex |
493 |
378 |
$8K |
| A4362 |
Solid skin barrier |
165 |
162 |
$8K |
| A4456 |
Adhesive remover, wipes |
906 |
854 |
$7K |
| A5120 |
Skin barrier, wipe or swab |
1,447 |
1,287 |
$7K |
| A4394 |
Ostomy pouch liq deodorant |
505 |
462 |
$2K |
| A4520 |
Incontinence garment anytype |
16 |
13 |
$2K |
| A4371 |
Skin barrier powder per oz |
549 |
528 |
$2K |
| T4521 |
Adult size brief/diaper sm |
26 |
25 |
$2K |
| A6402 |
Sterile gauze <= 16 sq in |
43 |
38 |
$398.35 |
| A4367 |
Ostomy belt |
109 |
105 |
$307.77 |
| A4406 |
Pectin based ostomy paste |
120 |
103 |
$267.35 |
| A4335 |
Incontinence supply |
49 |
49 |
$257.19 |
| A4338 |
Indwelling catheter latex |
16 |
14 |
$204.77 |
| A6250 |
Skin seal protect moisturizr |
13 |
12 |
$90.71 |
| A4334 |
Urinary cath leg strap |
20 |
12 |
$9.88 |