| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
1,193 |
967 |
$234K |
| 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 |
176 |
148 |
$90K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
270 |
219 |
$41K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
848 |
701 |
$28K |
| 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 |
335 |
285 |
$21K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
138 |
114 |
$18K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,799 |
1,587 |
$15K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,221 |
1,084 |
$12K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
15 |
12 |
$10K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
47 |
43 |
$6K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
13 |
13 |
$6K |
| 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 |
16 |
15 |
$762.36 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
215 |
193 |
$681.75 |
| A4402 |
Lubricant, per ounce |
44 |
36 |
$240.72 |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
14 |
14 |
$131.26 |
| A6260 |
Wound cleansers, any type, any size |
41 |
39 |
$0.00 |