| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
386 |
326 |
$158K |
| A4351 |
Straight tip urine catheter |
1,351 |
1,196 |
$25K |
| A4352 |
Coude tip urinary catheter |
336 |
302 |
$5K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
140 |
124 |
$3K |
| A4425 |
Ost pch drain for barrier fl |
130 |
115 |
$2K |
| A4357 |
Bedside drainage bag |
326 |
309 |
$2K |
| A4362 |
Solid skin barrier |
95 |
89 |
$2K |
| A4456 |
Adhesive remover, wipes |
390 |
355 |
$1K |
| A5120 |
Skin barrier, wipe or swab |
389 |
354 |
$998.13 |
| A4407 |
Ext wear ost skn barr <=4sq" |
40 |
36 |
$941.22 |
| A4409 |
Ost skn barr convex <=4 sq i |
12 |
12 |
$732.94 |
| A4385 |
Ost skn barrier sld ext wear |
55 |
52 |
$730.07 |
| A4332 |
Lube sterile packet |
529 |
482 |
$595.11 |
| A4358 |
Urinary leg or abdomen bag |
85 |
79 |
$350.54 |
| A4927 |
Non-sterile gloves |
15 |
12 |
$90.96 |
| A4406 |
Pectin based ostomy paste |
12 |
12 |
$85.76 |
| A4402 |
Lubricant per ounce |
50 |
50 |
$37.60 |