| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,326 |
1,150 |
$202K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
1,480 |
661 |
$49K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
276 |
127 |
$13K |
| A4927 |
Gloves, non-sterile, per 100 |
670 |
540 |
$13K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
54 |
36 |
$3K |
| A4402 |
Lubricant, per ounce |
1,172 |
866 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
233 |
177 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
107 |
80 |
$1K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
58 |
48 |
$569.20 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
51 |
39 |
$298.28 |