| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
1,228 |
1,079 |
$107K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
110 |
103 |
$48K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,503 |
1,332 |
$24K |
| A6260 |
Wound cleansers, any type, any size |
428 |
367 |
$9K |
| A4927 |
Gloves, non-sterile, per 100 |
235 |
214 |
$2K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
12 |
12 |
$1K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
16 |
12 |
$856.21 |
| A6444 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to 5 inches, per yard |
14 |
13 |
$557.75 |