| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,335 |
1,335 |
$320K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,878 |
1,873 |
$249K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
921 |
919 |
$56K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
664 |
663 |
$54K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
247 |
247 |
$45K |
| A5120 |
Skin barrier, wipes or swabs, each |
2,270 |
2,262 |
$40K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
938 |
935 |
$35K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
312 |
311 |
$32K |
| A4927 |
Gloves, non-sterile, per 100 |
2,003 |
2,002 |
$31K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
69 |
69 |
$23K |
| A4554 |
Disposable underpads, all sizes |
167 |
167 |
$23K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,225 |
1,212 |
$21K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
766 |
764 |
$18K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
415 |
415 |
$10K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
115 |
115 |
$7K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
263 |
262 |
$6K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
147 |
147 |
$4K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
12 |
12 |
$2K |
| A4371 |
Ostomy skin barrier, powder, per oz |
388 |
388 |
$2K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
13 |
13 |
$2K |
| A4452 |
Tape, waterproof, per 18 square inches |
12 |
12 |
$190.40 |