| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Special med equip, noswaiver |
24,695 |
23,046 |
$5.39M |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
943 |
853 |
$73K |
| A4362 |
Solid skin barrier |
1,235 |
1,053 |
$54K |
| A5063 |
Drain ostomy pouch w/flange |
1,288 |
1,107 |
$40K |
| A4409 |
Ost skn barr convex <=4 sq i |
911 |
752 |
$38K |
| A4406 |
Pectin based ostomy paste |
2,112 |
1,834 |
$25K |
| A4385 |
Ost skn barrier sld ext wear |
1,289 |
1,067 |
$22K |
| L8000 |
Mastectomy bra |
1,003 |
589 |
$20K |
| A4407 |
Ext wear ost skn barr <=4sq" |
339 |
280 |
$18K |
| A4425 |
Ost pch drain for barrier fl |
346 |
288 |
$17K |
| A5120 |
Skin barrier, wipe or swab |
2,114 |
1,786 |
$10K |
| A4357 |
Bedside drainage bag |
1,703 |
1,473 |
$9K |
| L8030 |
Breast prosthes w/o adhesive |
70 |
54 |
$6K |
| A4351 |
Straight tip urine catheter |
45 |
38 |
$5K |
| A4419 |
Ost pch for bar w flange/flt |
41 |
37 |
$3K |
| K0001 |
Standard wheelchair |
335 |
239 |
$3K |
| A5061 |
Pouch drainable w barrier at |
75 |
63 |
$3K |
| A4388 |
Drainable pch w ex wear barr |
84 |
77 |
$3K |
| A4432 |
Os pch urine w bar/fange/tap |
35 |
26 |
$1K |
| E0601 |
Cont airway pressure device |
87 |
84 |
$1K |
| A4367 |
Ostomy belt |
132 |
106 |
$623.17 |
| A4358 |
Urinary leg or abdomen bag |
30 |
27 |
$117.88 |
| E0156 |
Walker seat attachment |
16 |
12 |
$46.81 |
| A4371 |
Skin barrier powder per oz |
13 |
12 |
$29.88 |