| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6196 |
Alginate dressing <=16 sq in |
749 |
664 |
$12K |
| A6010 |
Collagen based wound filler |
115 |
102 |
$3K |
| A6212 |
Foam drg <=16 sq in w/border |
229 |
198 |
$3K |
| A6197 |
Alginate drsg >16 <=48 sq in |
115 |
98 |
$3K |
| A6446 |
Conform band s w>=3" <5"/yd |
498 |
440 |
$1K |
| A4452 |
Waterproof tape |
352 |
316 |
$818.95 |
| A6203 |
Composite drsg <= 16 sq in |
190 |
172 |
$779.45 |
| A6021 |
Collagen dressing <=16 sq in |
53 |
47 |
$594.86 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
138 |
126 |
$391.95 |
| A6219 |
Gauze <= 16 sq in w/border |
257 |
233 |
$387.81 |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
35 |
30 |
$288.52 |
| A4333 |
Urinary cath anchor device |
48 |
42 |
$50.99 |
| A4314 |
Cath w/drainage 2-way latex |
47 |
38 |
$34.50 |
| A4357 |
Bedside drainage bag |
31 |
31 |
$4.18 |
| A4334 |
Urinary cath leg strap |
12 |
12 |
$4.02 |
| A5120 |
Skin barrier, wipe or swab |
18 |
15 |
$0.00 |