| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
1,255 |
939 |
$716K |
| A4376 |
Ostomy pouch, drainable, with faceplate attached, rubber, each |
969 |
638 |
$637K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
1,265 |
901 |
$575K |
| A6211 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
623 |
487 |
$496K |
| A6224 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
1,386 |
946 |
$452K |
| A6244 |
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
474 |
352 |
$397K |
| A6452 |
High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard |
572 |
417 |
$286K |
| A4217 |
Sterile water/saline, 500 ml |
1,598 |
1,178 |
$284K |
| A4927 |
Gloves, non-sterile, per 100 |
2,299 |
1,559 |
$209K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
2,337 |
1,839 |
$207K |
| 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 |
565 |
415 |
$167K |
| A6236 |
Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
139 |
114 |
$149K |
| A6260 |
Wound cleansers, any type, any size |
1,084 |
593 |
$113K |
| T4541 |
Incontinence product, disposable underpad, large, each |
2,173 |
1,564 |
$77K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,877 |
1,154 |
$74K |
| B4100 |
Food thickener, administered orally, per ounce |
111 |
101 |
$60K |
| A6447 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to five inches, per yard |
316 |
249 |
$31K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
118 |
85 |
$27K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
425 |
259 |
$14K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,053 |
711 |
$13K |
| A4375 |
Ostomy pouch, drainable, with faceplate attached, plastic, each |
25 |
24 |
$5K |
| T4544 |
Adult sized disposable incontinence product, protective underwear/pull-on, above extra large, each |
106 |
73 |
$2K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
206 |
189 |
$2K |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
93 |
86 |
$778.04 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
28 |
12 |
$242.32 |