| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
12,016 |
9,254 |
$4.13M |
| A4351 |
Straight tip urine catheter |
21,959 |
17,529 |
$909K |
| A4352 |
Coude tip urinary catheter |
4,476 |
3,409 |
$421K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
5,400 |
4,042 |
$170K |
| A5061 |
Pouch drainable w barrier at |
4,147 |
3,078 |
$139K |
| A4362 |
Solid skin barrier |
4,290 |
3,653 |
$122K |
| A4409 |
Ost skn barr convex <=4 sq i |
4,368 |
3,023 |
$111K |
| A5063 |
Drain ostomy pouch w/flange |
5,682 |
3,952 |
$91K |
| A5071 |
Urinary pouch w/barrier |
656 |
570 |
$79K |
| A4385 |
Ost skn barrier sld ext wear |
4,487 |
3,103 |
$65K |
| A4332 |
Lube sterile packet |
6,989 |
5,038 |
$65K |
| A4407 |
Ext wear ost skn barr <=4sq" |
2,051 |
1,432 |
$57K |
| A4456 |
Adhesive remover, wipes |
13,799 |
10,140 |
$49K |
| A4927 |
Non-sterile gloves |
4,104 |
3,390 |
$49K |
| A4425 |
Ost pch drain for barrier fl |
4,463 |
3,278 |
$48K |
| A4349 |
Disposable male external cat |
1,833 |
1,294 |
$43K |
| A4357 |
Bedside drainage bag |
5,213 |
4,055 |
$35K |
| A5120 |
Skin barrier, wipe or swab |
13,021 |
10,086 |
$32K |
| T4534 |
Youth size pull-on |
461 |
391 |
$30K |
| A4406 |
Pectin based ostomy paste |
4,110 |
2,757 |
$27K |
| A4371 |
Skin barrier powder per oz |
3,636 |
2,780 |
$21K |
| A4554 |
Disposable underpads |
641 |
502 |
$17K |
| A4394 |
Ostomy pouch liq deodorant |
3,531 |
2,349 |
$16K |
| A5054 |
Clsd ostomy pouch w/flange |
557 |
477 |
$16K |
| A9900 |
Supply/accessory/service |
366 |
309 |
$12K |
| A5056 |
1 pc ost pouch w filter |
373 |
340 |
$10K |
| A4367 |
Ostomy belt |
1,758 |
1,470 |
$10K |
| A4432 |
Os pch urine w bar/fange/tap |
1,349 |
977 |
$9K |
| A4424 |
Ost pch drain w bar & filter |
251 |
235 |
$8K |
| T4530 |
Ped size brief/diaper lg |
138 |
125 |
$8K |
| A4358 |
Urinary leg or abdomen bag |
2,766 |
2,094 |
$7K |
| A4402 |
Lubricant per ounce |
2,995 |
2,255 |
$7K |
| T4522 |
Adult size brief/diaper med |
83 |
64 |
$6K |
| A4452 |
Waterproof tape |
723 |
617 |
$6K |
| A4338 |
Indwelling catheter latex |
562 |
481 |
$5K |
| A5057 |
1 pc ost pou w built-in conv |
62 |
57 |
$4K |
| A4310 |
Insert tray w/o bag/cath |
284 |
249 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
30 |
12 |
$2K |
| A4213 |
20+ cc syringe only |
105 |
89 |
$2K |
| T4521 |
Adult size brief/diaper sm |
13 |
12 |
$1K |
| B4150 |
Ef complet w/intact nutrient |
14 |
12 |
$934.09 |
| A4419 |
Ost pch for bar w flange/flt |
113 |
90 |
$892.76 |
| A4405 |
Nonpectin based ostomy paste |
165 |
151 |
$586.74 |
| A4369 |
Skin barrier liquid per oz |
375 |
333 |
$551.95 |
| A4344 |
Cath indw foley 2 way silicn |
19 |
13 |
$523.01 |
| A6216 |
Non-sterile gauze<=16 sq in |
90 |
63 |
$502.29 |
| A4455 |
Adhesive remover per ounce |
686 |
579 |
$411.94 |