| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6010 |
Collagen based wound filler |
420 |
394 |
$56K |
| A6196 |
Alginate dressing <=16 sq in |
427 |
398 |
$17K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
232 |
214 |
$4K |
| A6446 |
Conform band s w>=3" <5"/yd |
468 |
437 |
$4K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
40 |
39 |
$3K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
219 |
212 |
$2K |
| A6219 |
Gauze <= 16 sq in w/border |
461 |
432 |
$2K |
| A6212 |
Foam drg <=16 sq in w/border |
69 |
67 |
$2K |
| A4452 |
Waterproof tape |
130 |
126 |
$2K |
| A4450 |
Non-waterproof tape |
135 |
122 |
$516.26 |
| A4649 |
Surgical supplies |
40 |
35 |
$384.12 |
| A6402 |
Sterile gauze <= 16 sq in |
90 |
88 |
$88.94 |
| A6240 |
Hydrocolld drg filler paste |
29 |
29 |
$61.44 |
| A6248 |
Hydrogel drsg gel filler |
15 |
15 |
$3.07 |