| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary catheter, with insertion supplies |
12,016 |
9,254 |
$4.13M |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
21,959 |
17,529 |
$909K |
| A4352 |
Intermittent urinary catheter; coude (curved) tip, with or without coating (teflon, silicone, or silicone elastomeric, etc.), each |
4,476 |
3,409 |
$421K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
5,400 |
4,042 |
$170K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
4,147 |
3,078 |
$139K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
4,290 |
3,653 |
$122K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
4,368 |
3,023 |
$111K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
5,682 |
3,952 |
$91K |
| A5071 |
Ostomy pouch, urinary; with barrier attached (1 piece), each |
656 |
570 |
$79K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
4,487 |
3,103 |
$65K |
| A4332 |
Lubricant, individual sterile packet, each |
6,989 |
5,038 |
$65K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
2,051 |
1,432 |
$57K |
| A4456 |
Adhesive remover, wipes, any type, each |
13,799 |
10,140 |
$49K |
| A4927 |
Gloves, non-sterile, per 100 |
4,104 |
3,390 |
$49K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
4,463 |
3,278 |
$48K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
1,833 |
1,294 |
$43K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
5,213 |
4,055 |
$35K |
| A5120 |
Skin barrier, wipes or swabs, each |
13,021 |
10,086 |
$32K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
461 |
391 |
$30K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
4,110 |
2,757 |
$27K |
| A4371 |
Ostomy skin barrier, powder, per oz |
3,636 |
2,780 |
$21K |
| A4554 |
Disposable underpads, all sizes |
641 |
502 |
$17K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
3,531 |
2,349 |
$16K |
| A5054 |
Ostomy pouch, closed; for use on barrier with flange (2 piece), each |
557 |
477 |
$16K |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
366 |
309 |
$12K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
373 |
340 |
$10K |
| A4367 |
Ostomy belt, each |
1,758 |
1,470 |
$10K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
1,349 |
977 |
$9K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
251 |
235 |
$8K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
138 |
125 |
$8K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
2,766 |
2,094 |
$7K |
| A4402 |
Lubricant, per ounce |
2,995 |
2,255 |
$7K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
83 |
64 |
$6K |
| A4452 |
Tape, waterproof, per 18 square inches |
723 |
617 |
$6K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
562 |
481 |
$5K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
62 |
57 |
$4K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
284 |
249 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
30 |
12 |
$2K |
| A4213 |
Syringe, sterile, 20 cc or greater, each |
105 |
89 |
$2K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
13 |
12 |
$1K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
14 |
12 |
$934.09 |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
113 |
90 |
$892.76 |
| A4405 |
Ostomy skin barrier, non-pectin based, paste, per ounce |
165 |
151 |
$586.74 |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
375 |
333 |
$551.95 |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
19 |
13 |
$523.01 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
90 |
63 |
$502.29 |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
686 |
579 |
$411.94 |