| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6010 |
Collagen based wound filler |
67,935 |
59,076 |
$5.29M |
| A6196 |
Alginate dressing <=16 sq in |
190,284 |
163,681 |
$4.85M |
| A6197 |
Alginate drsg >16 <=48 sq in |
71,153 |
60,741 |
$3.80M |
| A6212 |
Foam drg <=16 sq in w/border |
94,122 |
79,186 |
$1.47M |
| A6021 |
Collagen dressing <=16 sq in |
38,442 |
33,466 |
$1.46M |
| A4452 |
Waterproof tape |
128,089 |
109,662 |
$876K |
| A6446 |
Conform band s w>=3" <5"/yd |
130,050 |
111,015 |
$779K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
41,984 |
36,063 |
$761K |
| A6023 |
Collagen dressing >48 sq in |
2,554 |
2,212 |
$724K |
| A6199 |
Alginate drsg wound filler |
21,441 |
18,441 |
$720K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
63,544 |
54,080 |
$645K |
| A6203 |
Composite drsg <= 16 sq in |
80,090 |
67,730 |
$615K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
28,140 |
22,983 |
$559K |
| A6449 |
Lt compres band >=3" <5"/yd |
17,176 |
14,570 |
$342K |
| A6248 |
Hydrogel drsg gel filler |
42,676 |
38,065 |
$290K |
| A4623 |
Tracheostomy inner cannula |
14,478 |
12,694 |
$272K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
43,427 |
37,912 |
$220K |
| A4414 |
Ost sknbar w/o conv<=4 sq in |
15,660 |
13,170 |
$169K |
| A4629 |
Tracheostomy care kit |
15,680 |
13,619 |
$166K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
16,368 |
14,666 |
$154K |
| A4333 |
Urinary cath anchor device |
71,859 |
62,496 |
$153K |
| A4314 |
Cath w/drainage 2-way latex |
67,483 |
58,916 |
$151K |
| A4357 |
Bedside drainage bag |
131,739 |
114,283 |
$149K |
| A6242 |
Hydrogel drg <=16 in w/o bdr |
14,337 |
12,868 |
$148K |
| A5063 |
Drain ostomy pouch w/flange |
22,929 |
19,221 |
$121K |
| A6022 |
Collagen drsg>16<=48 sq in |
3,333 |
2,886 |
$116K |
| A4409 |
Ost skn barr convex <=4 sq i |
10,754 |
9,056 |
$110K |
| A6237 |
Hydrocolld drg <=16 in w/bdr |
11,345 |
9,863 |
$107K |
| A6452 |
High compres band w>=3"<5"yd |
1,385 |
1,188 |
$102K |
| A4407 |
Ext wear ost skn barr <=4sq" |
6,037 |
5,178 |
$95K |
| A6231 |
Hydrogel dsg<=16 sq in |
10,057 |
8,983 |
$91K |
| A4315 |
Cath w/drainage 2-way silcne |
42,129 |
36,975 |
$89K |
| A7526 |
Tracheostomy tube collar |
15,168 |
13,277 |
$84K |
| A4394 |
Ostomy pouch liq deodorant |
20,969 |
17,674 |
$80K |
| A5061 |
Pouch drainable w barrier at |
9,062 |
7,849 |
$80K |
| A6454 |
Self-adher band w>=3" <5"/yd |
12,602 |
10,653 |
$79K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
9,949 |
8,708 |
$78K |
| A4450 |
Non-waterproof tape |
22,766 |
19,837 |
$78K |
| A6245 |
Hydrogel drg <= 16 in w/bdr |
6,383 |
5,850 |
$74K |
| A6456 |
Zinc paste band w >=3"<5"/yd |
7,102 |
6,026 |
$67K |
| A6211 |
Foam drg > 48 sq in w/o brdr |
1,729 |
1,463 |
$63K |
| A6204 |
Composite drsg >16<=48 sq in |
4,527 |
3,629 |
$59K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
9,537 |
8,227 |
$57K |
| A4425 |
Ost pch drain for barrier fl |
10,946 |
9,459 |
$57K |
| A6258 |
Transparent film >16<=48 in |
4,953 |
4,457 |
$55K |
| A6235 |
Hydrocolld drg >16<=48 w/o b |
2,612 |
2,272 |
$54K |
| A6402 |
Sterile gauze <= 16 sq in |
29,169 |
25,055 |
$53K |
| A4320 |
Irrigation tray |
11,586 |
10,161 |
$53K |
| A4358 |
Urinary leg or abdomen bag |
28,423 |
24,398 |
$49K |
| A4456 |
Adhesive remover, wipes |
31,874 |
26,972 |
$48K |
| A4385 |
Ost skn barrier sld ext wear |
5,369 |
4,470 |
$48K |
| A5120 |
Skin barrier, wipe or swab |
42,967 |
36,437 |
$47K |
| A4406 |
Pectin based ostomy paste |
14,693 |
12,230 |
$42K |
| A4334 |
Urinary cath leg strap |
64,952 |
56,507 |
$41K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
2,994 |
2,413 |
$38K |
| A6266 |
Impreg gauze no h20/sal/yard |
6,404 |
5,629 |
$31K |
| A4424 |
Ost pch drain w bar & filter |
4,041 |
3,448 |
$31K |
| A4419 |
Ost pch for bar w flange/flt |
2,892 |
2,430 |
$31K |
| A6243 |
Hydrogel drg >16<=48 w/o bdr |
1,367 |
1,224 |
$28K |
| A4388 |
Drainable pch w ex wear barr |
3,453 |
3,015 |
$26K |
| A6259 |
Transparent film > 48 sq in |
1,358 |
1,143 |
$22K |
| A4432 |
Os pch urine w bar/fange/tap |
2,920 |
2,440 |
$22K |
| A4362 |
Solid skin barrier |
4,462 |
3,625 |
$21K |
| A4340 |
Indwelling catheter special |
6,437 |
5,635 |
$21K |
| A7521 |
Trach/laryn tube cuffed |
5,427 |
4,861 |
$21K |
| A6219 |
Gauze <= 16 sq in w/border |
6,093 |
5,500 |
$19K |
| A7520 |
Trach/laryn tube non-cuffed |
2,489 |
2,185 |
$18K |
| A4410 |
Ost skn barr extnd >4 sq |
2,129 |
1,783 |
$18K |
| A4415 |
Ost skn barr w/o conv >4 sqi |
2,109 |
1,773 |
$18K |
| A4353 |
Intermittent urinary cath |
551 |
483 |
$17K |
| A4373 |
Skin barrier with flange |
1,609 |
1,372 |
$16K |
| A6407 |
Packing strips, non-impreg |
2,946 |
2,525 |
$14K |
| A4371 |
Skin barrier powder per oz |
11,433 |
9,802 |
$14K |
| A6198 |
Alginate dressing > 48 sq in |
183 |
159 |
$14K |
| A5131 |
Appliance cleaner |
6,438 |
5,512 |
$13K |
| A6545 |
Grad com non-elastic bk surg |
638 |
411 |
$12K |
| A4354 |
Cath insertion tray w/bag |
9,668 |
8,568 |
$12K |
| A5054 |
Clsd ostomy pouch w/flange |
1,043 |
804 |
$11K |
| A6441 |
Pad band w>=3" <5"/yd |
2,814 |
2,313 |
$11K |
| A6240 |
Hydrocolld drg filler paste |
1,159 |
1,048 |
$10K |
| A5056 |
1 pc ost pouch w filter |
1,222 |
1,023 |
$10K |
| A6443 |
Conform band n/s w>=3"<5"/yd |
2,516 |
2,070 |
$8K |
| A4417 |
Ost pch w bar/bltinconv/fltr |
429 |
331 |
$7K |
| A6257 |
Transparent film <= 16 sq in |
1,786 |
1,597 |
$7K |
| A4351 |
Straight tip urine catheter |
324 |
276 |
$7K |
| A4428 |
Urine ost pouch w faucet/tap |
791 |
685 |
$7K |
| A6457 |
Tubular dressing |
1,605 |
1,373 |
$6K |
| A4344 |
Cath indw foley 2 way silicn |
3,493 |
3,084 |
$5K |
| L8501 |
Tracheostomy speaking valve |
927 |
772 |
$5K |
| A4311 |
Catheter w/o bag 2-way latex |
2,441 |
2,186 |
$4K |
| A6246 |
Hydrogel drg >16<=48 in w/b |
342 |
301 |
$4K |
| A4338 |
Indwelling catheter latex |
3,360 |
2,987 |
$4K |
| A4349 |
Disposable male external cat |
351 |
283 |
$3K |
| A6216 |
Non-sterile gauze<=16 sq in |
1,043 |
931 |
$3K |
| A6453 |
Self-adher band w <3"/yd |
364 |
315 |
$2K |
| A6220 |
Gauze >16 <=48 sq in w/bordr |
419 |
378 |
$2K |
| A4312 |
Cath w/o bag 2-way silicone |
1,281 |
1,123 |
$2K |
| A4364 |
Adhesive, liquid or equal |
822 |
721 |
$2K |
| A4363 |
Ostomy clamp, replacement |
3,658 |
3,234 |
$2K |
| A4416 |
Ost pch clsd w barrier/filtr |
96 |
75 |
$900.70 |
| A4367 |
Ostomy belt |
733 |
615 |
$894.15 |
| A4430 |
Ost urine pch w b/bltin conv |
29 |
24 |
$835.72 |
| A6207 |
Contact layer >16<= 48 sq in |
68 |
60 |
$789.97 |
| A4405 |
Nonpectin based ostomy paste |
303 |
253 |
$713.40 |
| A6232 |
Hydrogel dsg>16<=48 sq in |
41 |
37 |
$501.43 |
| A4310 |
Insert tray w/o bag/cath |
518 |
479 |
$408.08 |
| A6451 |
Mod compres band w>=3"<5"/yd |
16 |
15 |
$250.52 |
| A4408 |
Ext wear ost skn barr >4sq" |
13 |
13 |
$213.27 |
| A5114 |
Foam/fabric leg strap |
193 |
183 |
$193.18 |
| A4369 |
Skin barrier liquid per oz |
124 |
111 |
$49.11 |
| A6254 |
Absorpt drg <=16 sq in w/bdr |
48 |
47 |
$46.22 |
| A4332 |
Lube sterile packet |
47 |
45 |
$24.36 |
| A4328 |
Fem urinary collect pouch |
12 |
12 |
$18.01 |