| 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 |
166 |
155 |
$9K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
266 |
241 |
$2K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
31 |
26 |
$2K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
30 |
28 |
$310.90 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
41 |
38 |
$256.99 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
166 |
149 |
$90.16 |
| A4452 |
Tape, waterproof, per 18 square inches |
15 |
13 |
$39.26 |