| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6203 |
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
399 |
356 |
$2K |
| A6204 |
Composite dressing, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
91 |
86 |
$743.11 |
| A6254 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
153 |
150 |
$485.61 |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
152 |
134 |
$100.36 |
| A6237 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
12 |
12 |
$0.00 |