| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99308 |
|
89,777 |
48,398 |
$977K |
| 11042 |
|
79,416 |
33,860 |
$741K |
| 99309 |
|
48,926 |
32,931 |
$739K |
| 11043 |
|
49,668 |
18,989 |
$504K |
| 97610 |
|
1,466 |
561 |
$100K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
1,748 |
1,351 |
$100K |
| 99307 |
|
8,215 |
6,949 |
$67K |
| 99305 |
|
2,490 |
2,482 |
$64K |
| 97597 |
|
6,626 |
3,121 |
$60K |
| 17250 |
|
24,346 |
11,394 |
$58K |
| 99310 |
Prolong nursin fac eval 15m |
2,204 |
1,894 |
$50K |
| 99306 |
Prolong nursin fac eval 15m |
1,036 |
1,032 |
$30K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,369 |
1,138 |
$10K |
| 99304 |
|
606 |
604 |
$9K |
| 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 |
362 |
271 |
$9K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
542 |
425 |
$9K |
| 11045 |
|
647 |
258 |
$6K |
| 11044 |
|
375 |
126 |
$6K |
| 99231 |
|
167 |
85 |
$3K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
773 |
582 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
202 |
116 |
$2K |
| 99232 |
|
57 |
27 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
60 |
38 |
$179.84 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
79 |
68 |
$60.60 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
31 |
25 |
$32.74 |