| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
973 |
673 |
$990K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,377 |
870 |
$536K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
2,003 |
1,919 |
$471K |
| A4554 |
Disposable underpads, all sizes |
6,705 |
6,413 |
$427K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
1,911 |
1,840 |
$377K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
5,554 |
5,047 |
$302K |
| A4927 |
Gloves, non-sterile, per 100 |
9,700 |
8,567 |
$217K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
473 |
329 |
$195K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
480 |
463 |
$171K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
225 |
149 |
$109K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
424 |
396 |
$100K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
488 |
463 |
$90K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
296 |
271 |
$81K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,032 |
1,493 |
$77K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
567 |
423 |
$55K |
| 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 |
269 |
146 |
$54K |
| A6260 |
Wound cleansers, any type, any size |
2,522 |
2,146 |
$48K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
49 |
24 |
$29K |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
209 |
132 |
$23K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
837 |
590 |
$22K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
89 |
72 |
$22K |
| A5120 |
Skin barrier, wipes or swabs, each |
1,919 |
1,811 |
$17K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
415 |
395 |
$14K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
477 |
430 |
$10K |
| A4452 |
Tape, waterproof, per 18 square inches |
728 |
518 |
$10K |
| A4371 |
Ostomy skin barrier, powder, per oz |
434 |
407 |
$7K |
| A6441 |
Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard |
111 |
67 |
$7K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
478 |
439 |
$3K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
78 |
73 |
$2K |
| A4331 |
Extension drainage tubing, any type, any length, with connector/adaptor, for use with urinary leg bag or urostomy pouch, each |
374 |
312 |
$1K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
86 |
81 |
$1K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
63 |
60 |
$271.92 |