| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
2,343 |
2,308 |
$150K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
1,711 |
1,636 |
$91K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
779 |
770 |
$83K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
1,685 |
1,633 |
$75K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
452 |
440 |
$51K |
| A4927 |
Gloves, non-sterile, per 100 |
2,262 |
2,221 |
$32K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
376 |
349 |
$21K |
| A4670 |
Automatic blood pressure monitor |
281 |
271 |
$15K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
448 |
432 |
$14K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
803 |
717 |
$13K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
219 |
213 |
$6K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
61 |
48 |
$6K |
| A4452 |
Tape, waterproof, per 18 square inches |
172 |
159 |
$4K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
357 |
346 |
$4K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
38 |
36 |
$2K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
29 |
28 |
$2K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
16 |
14 |
$1K |
| A4456 |
Adhesive remover, wipes, any type, each |
203 |
197 |
$995.00 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
76 |
76 |
$678.76 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
83 |
74 |
$590.08 |
| A4371 |
Ostomy skin barrier, powder, per oz |
178 |
169 |
$357.10 |
| A5120 |
Skin barrier, wipes or swabs, each |
42 |
39 |
$314.23 |
| A4367 |
Ostomy belt, each |
55 |
51 |
$155.69 |