| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
2,976 |
2,796 |
$134K |
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
1,094 |
1,023 |
$134K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
1,095 |
992 |
$114K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,227 |
1,144 |
$25K |
| A4623 |
Tracheostomy, inner cannula |
903 |
746 |
$21K |
| A6203 |
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,610 |
1,509 |
$20K |
| A6252 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
1,046 |
957 |
$18K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
2,241 |
2,112 |
$16K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,856 |
1,725 |
$14K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
267 |
251 |
$11K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
398 |
365 |
$10K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
2,281 |
2,092 |
$8K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
2,032 |
1,859 |
$7K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
3,937 |
3,582 |
$7K |
| A4629 |
Tracheostomy care kit for established tracheostomy |
907 |
748 |
$7K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
95 |
92 |
$5K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
713 |
686 |
$4K |
| A7526 |
Tracheostomy tube collar/holder, each |
790 |
665 |
$3K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
138 |
116 |
$3K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
734 |
667 |
$3K |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
1,887 |
1,742 |
$1K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
436 |
423 |
$1K |
| A4315 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone |
407 |
380 |
$1K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
210 |
195 |
$903.11 |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
233 |
173 |
$688.06 |
| A6242 |
Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
27 |
26 |
$299.98 |
| A5120 |
Skin barrier, wipes or swabs, each |
472 |
443 |
$288.96 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
247 |
215 |
$207.48 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
84 |
82 |
$87.82 |
| A4456 |
Adhesive remover, wipes, any type, each |
105 |
99 |
$38.64 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
12 |
12 |
$32.16 |
| A4626 |
Tracheostomy cleaning brush, each |
129 |
89 |
$30.96 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
12 |
12 |
$0.00 |