| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Straight tip urine catheter |
1,335 |
1,335 |
$320K |
| A4385 |
Ost skn barrier sld ext wear |
1,878 |
1,873 |
$249K |
| A5063 |
Drain ostomy pouch w/flange |
921 |
919 |
$56K |
| A4425 |
Ost pch drain for barrier fl |
664 |
663 |
$54K |
| A4409 |
Ost skn barr convex <=4 sq i |
247 |
247 |
$45K |
| A5120 |
Skin barrier, wipe or swab |
2,270 |
2,262 |
$40K |
| A4357 |
Bedside drainage bag |
938 |
935 |
$35K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
312 |
311 |
$32K |
| A4927 |
Non-sterile gloves |
2,003 |
2,002 |
$31K |
| A5121 |
Solid skin barrier 6x6 |
69 |
69 |
$23K |
| A4554 |
Disposable underpads |
167 |
167 |
$23K |
| A4358 |
Urinary leg or abdomen bag |
1,225 |
1,212 |
$21K |
| A4406 |
Pectin based ostomy paste |
766 |
764 |
$18K |
| A6402 |
Sterile gauze <= 16 sq in |
415 |
415 |
$10K |
| A4338 |
Indwelling catheter latex |
115 |
115 |
$7K |
| A4394 |
Ostomy pouch liq deodorant |
263 |
262 |
$6K |
| A4310 |
Insert tray w/o bag/cath |
147 |
147 |
$4K |
| A4520 |
Incontinence garment anytype |
12 |
12 |
$2K |
| A4371 |
Skin barrier powder per oz |
388 |
388 |
$2K |
| A4407 |
Ext wear ost skn barr <=4sq" |
13 |
13 |
$2K |
| A4452 |
Waterproof tape |
12 |
12 |
$190.40 |