| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
1,653 |
932 |
$41K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,866 |
1,212 |
$21K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
2,261 |
1,257 |
$16K |
| L0625 |
Lumbar orthosis, flexible, provides lumbar support, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include pendulous abdomen design, shoulder straps, stays, prefabricated, off-the-shelf |
333 |
315 |
$13K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
38 |
37 |
$10K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,466 |
1,763 |
$9K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
431 |
268 |
$8K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
186 |
119 |
$6K |
| 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 |
134 |
87 |
$6K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
274 |
173 |
$5K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
138 |
94 |
$3K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,169 |
812 |
$3K |
| 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 |
106 |
74 |
$2K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
36 |
13 |
$790.20 |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
75 |
52 |
$760.97 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
46 |
28 |
$166.65 |