| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6021 |
Collagen dressing <=16 sq in |
5,367 |
4,572 |
$1.39M |
| A6196 |
Alginate dressing <=16 sq in |
8,906 |
7,495 |
$902K |
| A6197 |
Alginate drsg >16 <=48 sq in |
2,026 |
1,775 |
$491K |
| A6446 |
Conform band s w>=3" <5"/yd |
12,701 |
10,877 |
$299K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
4,906 |
4,180 |
$261K |
| A6212 |
Foam drg <=16 sq in w/border |
3,047 |
2,576 |
$162K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
3,001 |
2,624 |
$139K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
3,160 |
2,601 |
$105K |
| A4452 |
Waterproof tape |
9,038 |
7,698 |
$91K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
2,457 |
2,102 |
$76K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
534 |
468 |
$73K |
| A6402 |
Sterile gauze <= 16 sq in |
11,782 |
10,188 |
$52K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
268 |
243 |
$28K |
| A6199 |
Alginate drsg wound filler |
140 |
125 |
$15K |
| A4450 |
Non-waterproof tape |
4,643 |
4,100 |
$14K |
| A6219 |
Gauze <= 16 sq in w/border |
652 |
533 |
$7K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
125 |
98 |
$4K |
| A6449 |
Lt compres band >=3" <5"/yd |
180 |
168 |
$2K |
| A6454 |
Self-adher band w>=3" <5"/yd |
276 |
234 |
$1K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
18 |
12 |
$382.18 |
| A6207 |
Contact layer >16<= 48 sq in |
12 |
12 |
$231.91 |