| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Straight tip urine catheter |
91,348 |
77,831 |
$8.58M |
| A4353 |
Intermittent urinary cath |
11,568 |
9,700 |
$5.48M |
| A4352 |
Coude tip urinary catheter |
13,487 |
11,327 |
$3.39M |
| A4385 |
Ost skn barrier sld ext wear |
31,640 |
27,575 |
$1.26M |
| A4409 |
Ost skn barr convex <=4 sq i |
20,077 |
17,075 |
$933K |
| A4362 |
Solid skin barrier |
31,019 |
27,062 |
$791K |
| A4407 |
Ext wear ost skn barr <=4sq" |
12,723 |
10,660 |
$694K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
17,828 |
15,093 |
$649K |
| A4425 |
Ost pch drain for barrier fl |
18,025 |
15,541 |
$480K |
| A5063 |
Drain ostomy pouch w/flange |
18,054 |
15,301 |
$357K |
| A4394 |
Ostomy pouch liq deodorant |
26,202 |
22,865 |
$346K |
| A4349 |
Disposable male external cat |
11,893 |
9,940 |
$287K |
| A5057 |
1 pc ost pou w built-in conv |
2,705 |
2,258 |
$256K |
| A4456 |
Adhesive remover, wipes |
39,349 |
34,352 |
$250K |
| A4357 |
Bedside drainage bag |
31,312 |
26,520 |
$214K |
| A5061 |
Pouch drainable w barrier at |
6,038 |
5,305 |
$197K |
| A4332 |
Lube sterile packet |
14,703 |
12,913 |
$182K |
| A5120 |
Skin barrier, wipe or swab |
33,142 |
29,075 |
$164K |
| A4406 |
Pectin based ostomy paste |
18,256 |
15,683 |
$161K |
| A4432 |
Os pch urine w bar/fange/tap |
6,151 |
5,106 |
$152K |
| A5056 |
1 pc ost pouch w filter |
2,724 |
2,248 |
$140K |
| A4424 |
Ost pch drain w bar & filter |
3,709 |
3,187 |
$135K |
| A4419 |
Ost pch for bar w flange/flt |
4,305 |
3,549 |
$134K |
| A4389 |
Drainable pch w st wear barr |
2,423 |
2,146 |
$131K |
| A5121 |
Solid skin barrier 6x6 |
2,617 |
2,245 |
$122K |
| A4373 |
Skin barrier with flange |
2,716 |
2,320 |
$117K |
| A4358 |
Urinary leg or abdomen bag |
21,735 |
18,436 |
$106K |
| A4416 |
Ost pch clsd w barrier/filtr |
1,733 |
1,343 |
$106K |
| L8000 |
Mastectomy bra |
4,881 |
4,474 |
$104K |
| A4328 |
Fem urinary collect pouch |
1,027 |
831 |
$97K |
| A4390 |
Drainable pch ex wear convex |
1,506 |
1,301 |
$97K |
| A4427 |
Ost pch drain/barr lk flng/f |
4,229 |
3,544 |
$91K |
| T4541 |
Large disposable underpad |
2,610 |
2,456 |
$90K |
| A7048 |
Vacuum drain bottle/tube kit |
208 |
153 |
$85K |
| A4388 |
Drainable pch w ex wear barr |
2,281 |
1,995 |
$81K |
| A5054 |
Clsd ostomy pouch w/flange |
2,330 |
1,957 |
$77K |
| L8030 |
Breast prosthes w/o adhesive |
1,112 |
954 |
$73K |
| A4452 |
Waterproof tape |
10,370 |
9,102 |
$65K |
| A5055 |
Stoma cap |
3,395 |
2,972 |
$63K |
| T4527 |
Adult size pull-on lg |
779 |
733 |
$58K |
| A4338 |
Indwelling catheter latex |
7,892 |
6,781 |
$54K |
| T4535 |
Disposable liner/shield/pad |
1,423 |
1,295 |
$52K |
| T4528 |
Adult size pull-on xl |
492 |
451 |
$51K |
| T4526 |
Adult size pull-on med |
844 |
761 |
$51K |
| A4402 |
Lubricant per ounce |
6,552 |
5,634 |
$49K |
| A4310 |
Insert tray w/o bag/cath |
5,233 |
4,380 |
$47K |
| A4430 |
Ost urine pch w b/bltin conv |
851 |
733 |
$46K |
| A4344 |
Cath indw foley 2 way silicn |
2,496 |
2,093 |
$46K |
| A4371 |
Skin barrier powder per oz |
15,669 |
13,700 |
$40K |
| A4367 |
Ostomy belt |
8,873 |
7,697 |
$36K |
| A4314 |
Cath w/drainage 2-way latex |
3,322 |
2,870 |
$32K |
| A4333 |
Urinary cath anchor device |
4,307 |
3,708 |
$31K |
| A4413 |
2 pc drainable ost pouch |
417 |
364 |
$22K |
| A6216 |
Non-sterile gauze<=16 sq in |
7,352 |
6,355 |
$22K |
| A4423 |
Ost pch for bar w lk fl/fltr |
516 |
436 |
$20K |
| L8020 |
Mastectomy form |
341 |
279 |
$20K |
| A4340 |
Indwelling catheter special |
549 |
470 |
$17K |
| A4393 |
Urine pch w ex wear bar conv |
390 |
320 |
$17K |
| A4415 |
Ost skn barr w/o conv >4 sqi |
454 |
406 |
$16K |
| A4410 |
Ost skn barr extnd >4 sq |
250 |
211 |
$15K |
| A4311 |
Catheter w/o bag 2-way latex |
1,564 |
1,365 |
$15K |
| A4364 |
Adhesive, liquid or equal |
1,721 |
1,586 |
$13K |
| K1006 |
Suct pum ext urine mgmt sys |
36 |
30 |
$11K |
| A4422 |
Ost pouch absorbent material |
2,176 |
1,907 |
$10K |
| A5131 |
Appliance cleaner |
1,089 |
946 |
$8K |
| A4369 |
Skin barrier liquid per oz |
2,822 |
2,378 |
$7K |
| A4428 |
Urine ost pouch w faucet/tap |
170 |
152 |
$6K |
| A4450 |
Non-waterproof tape |
2,718 |
2,328 |
$6K |
| A5102 |
Bedside drain btl w/wo tube |
492 |
404 |
$5K |
| A4315 |
Cath w/drainage 2-way silcne |
370 |
315 |
$5K |
| A4927 |
Non-sterile gloves |
481 |
423 |
$5K |
| A5073 |
Urinary pouch on barr w/flng |
190 |
179 |
$4K |
| E1399 |
Durable medical equipment mi |
135 |
54 |
$4K |
| A4322 |
Irrigation syringe |
555 |
488 |
$3K |
| A4433 |
Urine ost pch bar w lock fln |
145 |
127 |
$3K |
| A4408 |
Ext wear ost skn barr >4sq" |
53 |
39 |
$3K |
| A4354 |
Cath insertion tray w/bag |
114 |
103 |
$442.32 |
| A4334 |
Urinary cath leg strap |
188 |
142 |
$348.12 |
| A4320 |
Irrigation tray |
80 |
66 |
$263.10 |
| A4405 |
Nonpectin based ostomy paste |
13 |
13 |
$219.28 |
| A4331 |
Extension drainage tubing |
19 |
12 |
$31.77 |