| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,912 |
1,531 |
$85K |
| A4927 |
Gloves, non-sterile, per 100 |
1,699 |
1,403 |
$26K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
276 |
217 |
$17K |
| T4541 |
Incontinence product, disposable underpad, large, each |
529 |
417 |
$9K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
89 |
86 |
$8K |
| A4456 |
Adhesive remover, wipes, any type, each |
2,284 |
1,763 |
$7K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
237 |
205 |
$6K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,933 |
1,465 |
$4K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
85 |
64 |
$4K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
335 |
241 |
$2K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
55 |
36 |
$986.51 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
62 |
40 |
$380.77 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
130 |
88 |
$230.55 |