| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6010 |
Collagen based wound filler |
2,943 |
2,749 |
$381K |
| A6196 |
Alginate dressing <=16 sq in |
5,248 |
4,881 |
$214K |
| A6197 |
Alginate drsg >16 <=48 sq in |
1,606 |
1,495 |
$180K |
| A4623 |
Tracheostomy inner cannula |
3,193 |
3,008 |
$157K |
| A7526 |
Tracheostomy tube collar |
2,793 |
2,644 |
$78K |
| A6199 |
Alginate drsg wound filler |
390 |
362 |
$54K |
| A6203 |
Composite drsg <= 16 sq in |
3,468 |
3,254 |
$40K |
| A6212 |
Foam drg <=16 sq in w/border |
1,689 |
1,579 |
$36K |
| A6021 |
Collagen dressing <=16 sq in |
1,204 |
1,099 |
$33K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
1,407 |
1,322 |
$27K |
| A6446 |
Conform band s w>=3" <5"/yd |
3,321 |
3,103 |
$24K |
| A4452 |
Waterproof tape |
3,266 |
3,073 |
$20K |
| A4314 |
Cath w/drainage 2-way latex |
3,731 |
3,489 |
$13K |
| A4357 |
Bedside drainage bag |
5,714 |
5,313 |
$13K |
| A7521 |
Trach/laryn tube cuffed |
582 |
581 |
$9K |
| A5061 |
Pouch drainable w barrier at |
333 |
304 |
$9K |
| A4333 |
Urinary cath anchor device |
2,956 |
2,713 |
$9K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
1,105 |
1,023 |
$5K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
507 |
459 |
$5K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
714 |
681 |
$3K |
| A7520 |
Trach/laryn tube non-cuffed |
83 |
83 |
$3K |
| A6245 |
Hydrogel drg <= 16 in w/bdr |
90 |
88 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
1,311 |
1,171 |
$2K |
| A4456 |
Adhesive remover, wipes |
1,085 |
966 |
$2K |
| A4629 |
Tracheostomy care kit |
242 |
224 |
$1K |
| A6248 |
Hydrogel drsg gel filler |
797 |
734 |
$1K |
| A4315 |
Cath w/drainage 2-way silcne |
1,095 |
1,010 |
$1K |
| A6231 |
Hydrogel dsg<=16 sq in |
29 |
28 |
$1K |
| A6204 |
Composite drsg >16<=48 sq in |
39 |
37 |
$992.40 |
| A4394 |
Ostomy pouch liq deodorant |
485 |
428 |
$984.80 |
| A4334 |
Urinary cath leg strap |
2,433 |
2,279 |
$715.54 |
| A6242 |
Hydrogel drg <=16 in w/o bdr |
115 |
109 |
$451.00 |
| A6219 |
Gauze <= 16 sq in w/border |
327 |
317 |
$448.15 |
| A4406 |
Pectin based ostomy paste |
126 |
112 |
$442.98 |
| A6237 |
Hydrocolld drg <=16 in w/bdr |
38 |
37 |
$301.05 |
| A4450 |
Non-waterproof tape |
90 |
84 |
$232.50 |
| A6402 |
Sterile gauze <= 16 sq in |
112 |
110 |
$103.52 |
| A4371 |
Skin barrier powder per oz |
151 |
137 |
$87.45 |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
26 |
26 |
$76.90 |
| A4358 |
Urinary leg or abdomen bag |
13 |
12 |
$36.64 |
| A4320 |
Irrigation tray |
30 |
27 |
$0.00 |