| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4333 |
Urinary cath anchor device |
1,782 |
1,777 |
$6K |
| A4357 |
Bedside drainage bag |
2,508 |
2,503 |
$5K |
| A4314 |
Cath w/drainage 2-way latex |
1,530 |
1,530 |
$4K |
| A4358 |
Urinary leg or abdomen bag |
1,388 |
1,381 |
$3K |
| B4035 |
Enteral feed supp pump per d |
217 |
149 |
$2K |
| A4315 |
Cath w/drainage 2-way silcne |
220 |
219 |
$620.05 |
| A4320 |
Irrigation tray |
823 |
822 |
$501.71 |
| B4152 |
Ef calorie dense>/=1.5kcal |
19 |
12 |
$288.45 |
| A4456 |
Adhesive remover, wipes |
107 |
107 |
$271.86 |
| A6240 |
Hydrocolld drg filler paste |
27 |
12 |
$200.83 |
| A4334 |
Urinary cath leg strap |
293 |
292 |
$149.20 |
| A6219 |
Gauze <= 16 sq in w/border |
138 |
77 |
$122.11 |
| A5120 |
Skin barrier, wipe or swab |
69 |
69 |
$91.47 |
| A4394 |
Ostomy pouch liq deodorant |
27 |
27 |
$17.12 |