| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
8,879 |
6,756 |
$4.32M |
| A4351 |
Straight tip urine catheter |
9,185 |
7,518 |
$776K |
| T4534 |
Youth size pull-on |
5,224 |
4,789 |
$600K |
| A4352 |
Coude tip urinary catheter |
1,837 |
1,476 |
$334K |
| T4530 |
Ped size brief/diaper lg |
2,507 |
2,349 |
$196K |
| A4385 |
Ost skn barrier sld ext wear |
3,578 |
2,857 |
$136K |
| T4541 |
Large disposable underpad |
4,561 |
4,125 |
$135K |
| A4409 |
Ost skn barr convex <=4 sq i |
2,685 |
2,184 |
$132K |
| T4529 |
Ped size brief/diaper sm/med |
1,053 |
1,002 |
$115K |
| T4526 |
Adult size pull-on med |
947 |
834 |
$67K |
| A4407 |
Ext wear ost skn barr <=4sq" |
932 |
716 |
$56K |
| A4425 |
Ost pch drain for barrier fl |
1,525 |
1,238 |
$48K |
| T4527 |
Adult size pull-on lg |
586 |
517 |
$47K |
| A4362 |
Solid skin barrier |
1,362 |
1,143 |
$43K |
| A5063 |
Drain ostomy pouch w/flange |
1,751 |
1,386 |
$36K |
| T4535 |
Disposable liner/shield/pad |
446 |
418 |
$22K |
| A4357 |
Bedside drainage bag |
2,947 |
2,222 |
$18K |
| A4394 |
Ostomy pouch liq deodorant |
1,421 |
1,109 |
$17K |
| A4927 |
Non-sterile gloves |
2,216 |
1,801 |
$17K |
| T4523 |
Adult size brief/diaper lg |
206 |
169 |
$16K |
| A5120 |
Skin barrier, wipe or swab |
3,376 |
2,812 |
$15K |
| A4456 |
Adhesive remover, wipes |
2,393 |
1,992 |
$14K |
| A4406 |
Pectin based ostomy paste |
1,682 |
1,453 |
$14K |
| T4522 |
Adult size brief/diaper med |
170 |
157 |
$12K |
| A4332 |
Lube sterile packet |
1,779 |
1,385 |
$12K |
| A4358 |
Urinary leg or abdomen bag |
1,543 |
1,115 |
$7K |
| T4528 |
Adult size pull-on xl |
88 |
79 |
$7K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
126 |
102 |
$5K |
| A4402 |
Lubricant per ounce |
1,738 |
1,481 |
$5K |
| A4371 |
Skin barrier powder per oz |
1,757 |
1,469 |
$3K |
| A4388 |
Drainable pch w ex wear barr |
94 |
62 |
$3K |
| A5057 |
1 pc ost pou w built-in conv |
60 |
38 |
$3K |
| T4531 |
Ped size pull-on sm/med |
15 |
14 |
$2K |
| A4217 |
Sterile water/saline, 500 ml |
94 |
75 |
$2K |
| A4338 |
Indwelling catheter latex |
60 |
53 |
$2K |
| A4310 |
Insert tray w/o bag/cath |
156 |
92 |
$2K |
| A4367 |
Ostomy belt |
366 |
301 |
$1K |
| A4520 |
Incontinence garment anytype |
54 |
45 |
$1K |
| A4452 |
Waterproof tape |
107 |
90 |
$919.74 |
| A4455 |
Adhesive remover per ounce |
251 |
205 |
$499.51 |