| 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 |
1,954 |
1,944 |
$1.14M |
| 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 |
1,317 |
1,306 |
$452K |
| 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 |
317 |
313 |
$397K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
946 |
941 |
$217K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
7,079 |
6,934 |
$212K |
| 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 |
1,206 |
1,197 |
$171K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
3,724 |
3,678 |
$166K |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
2,615 |
2,592 |
$161K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
895 |
890 |
$143K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
489 |
488 |
$139K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
777 |
776 |
$92K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
3,589 |
3,491 |
$84K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
645 |
642 |
$80K |
| A4927 |
Gloves, non-sterile, per 100 |
3,242 |
3,217 |
$80K |
| A4217 |
Sterile water/saline, 500 ml |
1,047 |
1,036 |
$57K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
122 |
122 |
$52K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
220 |
219 |
$52K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
390 |
380 |
$47K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
189 |
187 |
$44K |
| A6404 |
Gauze, non-impregnated, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
584 |
581 |
$42K |
| T4541 |
Incontinence product, disposable underpad, large, each |
653 |
650 |
$38K |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
481 |
480 |
$33K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
985 |
981 |
$33K |
| A5120 |
Skin barrier, wipes or swabs, each |
2,223 |
2,213 |
$23K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
686 |
685 |
$23K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
464 |
464 |
$21K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
104 |
104 |
$18K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
436 |
436 |
$15K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
464 |
463 |
$14K |
| A4456 |
Adhesive remover, wipes, any type, each |
1,282 |
1,278 |
$13K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
497 |
492 |
$12K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
311 |
311 |
$11K |
| A4371 |
Ostomy skin barrier, powder, per oz |
791 |
787 |
$10K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
122 |
122 |
$10K |
| A6456 |
Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
28 |
28 |
$4K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
150 |
150 |
$3K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
26 |
26 |
$3K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
49 |
49 |
$3K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
52 |
52 |
$3K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
39 |
39 |
$2K |
| A4367 |
Ostomy belt, each |
254 |
251 |
$2K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
13 |
13 |
$2K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
40 |
40 |
$2K |
| A6260 |
Wound cleansers, any type, any size |
25 |
14 |
$2K |
| A4246 |
Betadine or phisohex solution, per pint |
44 |
44 |
$2K |
| A4402 |
Lubricant, per ounce |
258 |
258 |
$1K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
12 |
12 |
$1K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12 |
12 |
$877.40 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
54 |
54 |
$678.96 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
12 |
12 |
$645.01 |