| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
10,513 |
7,671 |
$92K |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
4,408 |
3,156 |
$68K |
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
2,313 |
1,839 |
$33K |
| 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 |
4,145 |
3,126 |
$18K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
1,285 |
1,041 |
$17K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
12,506 |
9,825 |
$14K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
5,167 |
3,864 |
$11K |
| A6210 |
Foam 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 |
1,137 |
828 |
$10K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
6,999 |
5,236 |
$8K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
3,919 |
3,032 |
$7K |
| A4452 |
Tape, waterproof, per 18 square inches |
6,463 |
4,770 |
$6K |
| A6220 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
1,671 |
1,238 |
$5K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
2,708 |
2,151 |
$3K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
687 |
560 |
$3K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
1,592 |
1,264 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,972 |
1,584 |
$1K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
775 |
659 |
$1K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,792 |
1,459 |
$1K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
546 |
479 |
$506.51 |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
18 |
12 |
$336.60 |
| A6223 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 16 sq. in., but less than or equal to 48 sq. in., without adhesive border, each dressing |
65 |
51 |
$323.04 |
| A6231 |
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing |
124 |
104 |
$293.23 |
| A6203 |
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
249 |
220 |
$270.69 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
597 |
515 |
$183.97 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
625 |
531 |
$119.39 |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
17 |
12 |
$20.88 |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
19 |
13 |
$18.95 |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
14 |
12 |
$0.00 |