| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
420 |
394 |
$56K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
427 |
398 |
$17K |
| 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 |
232 |
214 |
$4K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
468 |
437 |
$4K |
| 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 |
40 |
39 |
$3K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
219 |
212 |
$2K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
461 |
432 |
$2K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
69 |
67 |
$2K |
| A4452 |
Tape, waterproof, per 18 square inches |
130 |
126 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
135 |
122 |
$516.26 |
| A4649 |
Surgical supply; miscellaneous |
40 |
35 |
$384.12 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
90 |
88 |
$88.94 |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
29 |
29 |
$61.44 |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
15 |
15 |
$3.07 |