| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Straight tip urine catheter |
3,866 |
2,762 |
$465K |
| A4353 |
Intermittent urinary cath |
561 |
411 |
$356K |
| A4554 |
Disposable underpads |
4,320 |
3,740 |
$245K |
| A4385 |
Ost skn barrier sld ext wear |
2,201 |
1,780 |
$155K |
| T4526 |
Adult size pull-on med |
987 |
885 |
$125K |
| A4409 |
Ost skn barr convex <=4 sq i |
1,023 |
846 |
$101K |
| T4527 |
Adult size pull-on lg |
717 |
619 |
$97K |
| A9270 |
Non-covered item or service |
50 |
40 |
$89K |
| A4453 |
Rec cath any transanal, each |
34 |
26 |
$48K |
| A5063 |
Drain ostomy pouch w/flange |
1,056 |
837 |
$43K |
| A4927 |
Non-sterile gloves |
2,121 |
1,847 |
$39K |
| A4217 |
Sterile water/saline, 500 ml |
560 |
431 |
$38K |
| A4394 |
Ostomy pouch liq deodorant |
2,171 |
1,661 |
$32K |
| A4456 |
Adhesive remover, wipes |
3,495 |
2,726 |
$27K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
301 |
231 |
$19K |
| A4425 |
Ost pch drain for barrier fl |
299 |
238 |
$19K |
| A4357 |
Bedside drainage bag |
1,818 |
1,365 |
$18K |
| A4352 |
Coude tip urinary catheter |
36 |
26 |
$17K |
| A4452 |
Waterproof tape |
1,106 |
755 |
$17K |
| A4459 |
Transanal irrigation, any |
94 |
77 |
$15K |
| T4528 |
Adult size pull-on xl |
120 |
87 |
$14K |
| A5120 |
Skin barrier, wipe or swab |
3,110 |
2,423 |
$13K |
| A4406 |
Pectin based ostomy paste |
1,180 |
929 |
$13K |
| A4362 |
Solid skin barrier |
240 |
192 |
$11K |
| A4371 |
Skin barrier powder per oz |
1,908 |
1,442 |
$9K |
| A4358 |
Urinary leg or abdomen bag |
854 |
622 |
$6K |
| A4367 |
Ostomy belt |
778 |
554 |
$3K |
| A4213 |
20+ cc syringe only |
93 |
76 |
$2K |
| E0202 |
Phototherapy light w/ photom |
14 |
12 |
$2K |
| A4402 |
Lubricant per ounce |
16 |
12 |
$51.31 |