| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
6,064 |
5,012 |
$3.11M |
| A4453 |
Rectal catheter with or without balloon, for use with any type transanal irrigation system, each |
66 |
63 |
$107K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,180 |
1,049 |
$52K |
| E1399 |
Durable medical equipment, miscellaneous |
46 |
38 |
$43K |
| A4459 |
Manual transanal irrigation system, includes water reservoir, pump, tubing, and accessories, without catheter, any type |
63 |
52 |
$29K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
497 |
441 |
$24K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,787 |
1,596 |
$16K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
215 |
190 |
$14K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
1,252 |
1,141 |
$12K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
104 |
95 |
$11K |
| A4217 |
Sterile water/saline, 500 ml |
508 |
427 |
$9K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
188 |
136 |
$9K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,279 |
1,159 |
$6K |
| A4554 |
Disposable underpads, all sizes |
295 |
244 |
$5K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
410 |
363 |
$4K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,379 |
1,226 |
$4K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,150 |
1,071 |
$3K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
89 |
73 |
$2K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
58 |
55 |
$2K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
148 |
130 |
$2K |
| A4371 |
Ostomy skin barrier, powder, per oz |
888 |
780 |
$1K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
74 |
73 |
$733.50 |
| T4541 |
Incontinence product, disposable underpad, large, each |
28 |
24 |
$446.53 |
| A9286 |
Hygienic item or device, disposable or non-disposable, any type, each |
56 |
37 |
$261.90 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
28 |
27 |
$223.64 |
| A4332 |
Lubricant, individual sterile packet, each |
14 |
12 |
$5.53 |