| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T4541 |
Incontinence product, disposable underpad, large, each |
6,317 |
5,975 |
$205K |
| A4335 |
Incontinence supply; miscellaneous |
3,459 |
3,375 |
$134K |
| T4537 |
Incontinence product, protective underpad, reusable, bed size, each |
2,617 |
2,440 |
$110K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,085 |
1,925 |
$102K |
| T4532 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, large size, each |
1,538 |
1,512 |
$101K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
1,486 |
1,389 |
$96K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,817 |
1,724 |
$83K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,125 |
1,098 |
$75K |
| T4543 |
Adult sized disposable incontinence product, protective brief/diaper, above extra large, each |
550 |
507 |
$62K |
| A4927 |
Gloves, non-sterile, per 100 |
6,784 |
5,909 |
$58K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
547 |
517 |
$58K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
604 |
572 |
$46K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
768 |
745 |
$45K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
891 |
863 |
$42K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
2,106 |
1,948 |
$33K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
461 |
441 |
$27K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
581 |
569 |
$26K |
| A4520 |
Incontinence garment, any type, (e.g., brief, diaper), each |
1,901 |
1,672 |
$26K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
356 |
352 |
$22K |
| A4554 |
Disposable underpads, all sizes |
1,905 |
1,668 |
$20K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
66 |
65 |
$9K |
| T4533 |
Youth sized disposable incontinence product, brief/diaper, each |
37 |
37 |
$3K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
43 |
40 |
$3K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
24 |
24 |
$2K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
12 |
12 |
$1K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
29 |
29 |
$1K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
83 |
80 |
$641.67 |
| A4332 |
Lubricant, individual sterile packet, each |
30 |
30 |
$319.02 |
| A4344 |
Indwelling catheter, foley type, two-way, all silicone or polyurethane, each |
14 |
14 |
$273.01 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
35 |
35 |
$271.64 |
| A4452 |
Tape, waterproof, per 18 square inches |
32 |
31 |
$253.41 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
22 |
22 |
$249.88 |
| T4542 |
Incontinence product, disposable underpad, small size, each |
13 |
13 |
$244.00 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
13 |
13 |
$184.04 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
15 |
14 |
$171.54 |
| A4553 |
Non-disposable underpads, all sizes |
436 |
400 |
$118.82 |
| A4402 |
Lubricant, per ounce |
26 |
24 |
$104.02 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
18 |
17 |
$91.62 |
| A4456 |
Adhesive remover, wipes, any type, each |
13 |
13 |
$79.22 |
| A5120 |
Skin barrier, wipes or swabs, each |
44 |
35 |
$74.58 |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
79 |
65 |
$50.63 |
| A4371 |
Ostomy skin barrier, powder, per oz |
12 |
12 |
$40.51 |