| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
177,261 |
157,135 |
$98.73M |
| A4351 |
Straight tip urine catheter |
267,873 |
237,361 |
$21.80M |
| A4352 |
Coude tip urinary catheter |
63,744 |
55,952 |
$14.42M |
| A4344 |
Cath indw foley 2 way silicn |
19,711 |
16,442 |
$1.68M |
| A4385 |
Ost skn barrier sld ext wear |
33,016 |
29,112 |
$1.53M |
| A4409 |
Ost skn barr convex <=4 sq i |
24,613 |
21,782 |
$1.25M |
| A4407 |
Ext wear ost skn barr <=4sq" |
19,251 |
16,869 |
$1.22M |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
23,619 |
21,120 |
$1.05M |
| A4425 |
Ost pch drain for barrier fl |
27,046 |
23,875 |
$876K |
| A4332 |
Lube sterile packet |
113,903 |
102,419 |
$874K |
| A4362 |
Solid skin barrier |
23,311 |
20,782 |
$728K |
| A4357 |
Bedside drainage bag |
55,757 |
49,615 |
$683K |
| T4526 |
Adult size pull-on med |
9,410 |
8,412 |
$662K |
| T4534 |
Youth size pull-on |
9,340 |
8,418 |
$647K |
| A4554 |
Disposable underpads |
14,843 |
12,656 |
$501K |
| A5063 |
Drain ostomy pouch w/flange |
22,146 |
19,587 |
$494K |
| A4322 |
Irrigation syringe |
13,862 |
12,752 |
$439K |
| A5061 |
Pouch drainable w barrier at |
10,401 |
8,974 |
$418K |
| T4527 |
Adult size pull-on lg |
5,448 |
4,769 |
$386K |
| A4349 |
Disposable male external cat |
10,206 |
8,639 |
$373K |
| A4927 |
Non-sterile gloves |
35,599 |
30,602 |
$362K |
| A4310 |
Insert tray w/o bag/cath |
14,125 |
12,490 |
$349K |
| T4541 |
Large disposable underpad |
9,379 |
8,516 |
$337K |
| T4522 |
Adult size brief/diaper med |
5,158 |
4,606 |
$330K |
| T4530 |
Ped size brief/diaper lg |
4,463 |
3,970 |
$317K |
| T4528 |
Adult size pull-on xl |
3,626 |
3,070 |
$302K |
| A5120 |
Skin barrier, wipe or swab |
64,449 |
57,419 |
$289K |
| T4523 |
Adult size brief/diaper lg |
3,582 |
3,172 |
$289K |
| A4389 |
Drainable pch w st wear barr |
4,277 |
3,901 |
$283K |
| A4358 |
Urinary leg or abdomen bag |
33,848 |
29,944 |
$281K |
| A4213 |
20+ cc syringe only |
13,872 |
12,540 |
$277K |
| A4424 |
Ost pch drain w bar & filter |
5,868 |
5,185 |
$259K |
| T4535 |
Disposable liner/shield/pad |
7,418 |
6,540 |
$247K |
| A4432 |
Os pch urine w bar/fange/tap |
10,498 |
9,238 |
$246K |
| A4456 |
Adhesive remover, wipes |
54,732 |
48,976 |
$245K |
| A5056 |
1 pc ost pouch w filter |
5,119 |
4,464 |
$243K |
| A4394 |
Ostomy pouch liq deodorant |
18,757 |
16,730 |
$238K |
| A4419 |
Ost pch for bar w flange/flt |
6,655 |
5,970 |
$225K |
| A5054 |
Clsd ostomy pouch w/flange |
3,867 |
3,422 |
$221K |
| T4525 |
Adult size pull-on sm |
3,024 |
2,685 |
$196K |
| T4532 |
Ped size pull-on lg |
2,538 |
2,326 |
$194K |
| A4217 |
Sterile water/saline, 500 ml |
11,673 |
10,158 |
$181K |
| T4524 |
Adult size brief/diaper xl |
1,949 |
1,718 |
$178K |
| A4402 |
Lubricant per ounce |
37,349 |
34,074 |
$177K |
| A4340 |
Indwelling catheter special |
2,688 |
2,330 |
$175K |
| A5057 |
1 pc ost pou w built-in conv |
1,700 |
1,467 |
$170K |
| T4521 |
Adult size brief/diaper sm |
2,406 |
2,143 |
$170K |
| A4406 |
Pectin based ostomy paste |
19,409 |
17,477 |
$166K |
| A4416 |
Ost pch clsd w barrier/filtr |
3,010 |
2,655 |
$161K |
| B4036 |
Enteral feed sup kit grav by |
7,708 |
6,876 |
$146K |
| A4338 |
Indwelling catheter latex |
10,322 |
9,199 |
$146K |
| T4533 |
Youth size brief/diaper |
2,009 |
1,814 |
$139K |
| A4413 |
2 pc drainable ost pouch |
1,980 |
1,665 |
$102K |
| A4452 |
Waterproof tape |
9,083 |
8,013 |
$82K |
| T4544 |
Adlt disp und/pull on abv xl |
573 |
494 |
$82K |
| A4247 |
Betadine/iodine swabs/wipes |
4,078 |
3,651 |
$80K |
| A4388 |
Drainable pch w ex wear barr |
1,877 |
1,688 |
$74K |
| A4390 |
Drainable pch ex wear convex |
1,242 |
1,105 |
$71K |
| A4428 |
Urine ost pouch w faucet/tap |
1,640 |
1,331 |
$71K |
| A4371 |
Skin barrier powder per oz |
23,254 |
20,985 |
$69K |
| A5121 |
Solid skin barrier 6x6 |
1,147 |
1,031 |
$63K |
| A4520 |
Incontinence garment anytype |
3,776 |
3,131 |
$61K |
| A4333 |
Urinary cath anchor device |
8,299 |
7,509 |
$61K |
| A4367 |
Ostomy belt |
13,613 |
12,123 |
$60K |
| A4410 |
Ost skn barr extnd >4 sq |
560 |
481 |
$59K |
| A5073 |
Urinary pouch on barr w/flng |
2,058 |
1,824 |
$59K |
| A4320 |
Irrigation tray |
1,889 |
1,650 |
$54K |
| A4399 |
Ostomy irrig cone/cath w brs |
4,108 |
3,731 |
$50K |
| A6212 |
Foam drg <=16 sq in w/border |
402 |
345 |
$48K |
| A4393 |
Urine pch w ex wear bar conv |
830 |
731 |
$45K |
| T4543 |
Adult disp brief/diap abv xl |
326 |
272 |
$38K |
| A4392 |
Urinary pouch w st wear barr |
552 |
479 |
$38K |
| B4035 |
Enteral feed supp pump per d |
502 |
456 |
$30K |
| A4335 |
Incontinence supply |
3,129 |
2,545 |
$29K |
| A4405 |
Nonpectin based ostomy paste |
4,609 |
4,185 |
$29K |
| T4537 |
Reusable underpad bed size |
757 |
688 |
$28K |
| A4400 |
Ostomy irrigation set |
577 |
554 |
$20K |
| A4369 |
Skin barrier liquid per oz |
6,365 |
5,768 |
$20K |
| A4427 |
Ost pch drain/barr lk flng/f |
686 |
608 |
$17K |
| A4314 |
Cath w/drainage 2-way latex |
2,898 |
2,553 |
$17K |
| A6216 |
Non-sterile gauze<=16 sq in |
4,138 |
3,683 |
$15K |
| A4415 |
Ost skn barr w/o conv >4 sqi |
315 |
285 |
$15K |
| A4245 |
Alcohol wipes per box |
274 |
237 |
$15K |
| A4334 |
Urinary cath leg strap |
4,017 |
3,640 |
$14K |
| A4455 |
Adhesive remover per ounce |
8,932 |
8,090 |
$13K |
| A6402 |
Sterile gauze <= 16 sq in |
1,403 |
1,273 |
$13K |
| A4331 |
Extension drainage tubing |
2,703 |
2,433 |
$10K |
| A4315 |
Cath w/drainage 2-way silcne |
1,447 |
1,176 |
$9K |
| A5081 |
Stoma plug or seal, any type |
1,185 |
1,073 |
$8K |
| A4450 |
Non-waterproof tape |
3,411 |
3,057 |
$8K |
| B9998 |
Enteral supp not otherwise c |
51 |
37 |
$7K |
| A4311 |
Catheter w/o bag 2-way latex |
707 |
619 |
$6K |
| A6258 |
Transparent film >16<=48 in |
67 |
62 |
$6K |
| T4531 |
Ped size pull-on sm/med |
79 |
66 |
$5K |
| A4364 |
Adhesive, liquid or equal |
913 |
804 |
$5K |
| T5999 |
Supply, nos |
268 |
193 |
$3K |
| A6257 |
Transparent film <= 16 sq in |
111 |
94 |
$3K |
| A4649 |
Surgical supplies |
703 |
594 |
$3K |
| A4373 |
Skin barrier with flange |
64 |
57 |
$2K |
| A4411 |
Ost skn barr extnd =4sq |
27 |
25 |
$2K |
| A4930 |
Sterile, gloves per pair |
32 |
24 |
$809.57 |
| A5055 |
Stoma cap |
27 |
24 |
$557.94 |
| A5102 |
Bedside drain btl w/wo tube |
101 |
81 |
$446.27 |
| A4422 |
Ost pouch absorbent material |
112 |
102 |
$296.62 |
| A9900 |
Supply/accessory/service |
31 |
28 |
$47.70 |
| A4354 |
Cath insertion tray w/bag |
16 |
12 |
$6.78 |