| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6010 |
Collagen based wound filler |
1,146 |
1,077 |
$177K |
| A6212 |
Foam drg <=16 sq in w/border |
998 |
932 |
$26K |
| A6196 |
Alginate dressing <=16 sq in |
779 |
733 |
$20K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
253 |
238 |
$4K |
| A6243 |
Hydrogel drg >16<=48 w/o bdr |
64 |
61 |
$4K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
229 |
216 |
$2K |
| A6446 |
Conform band s w>=3" <5"/yd |
523 |
482 |
$2K |
| A6219 |
Gauze <= 16 sq in w/border |
274 |
253 |
$2K |
| A6242 |
Hydrogel drg <=16 in w/o bdr |
94 |
93 |
$1K |
| A6197 |
Alginate drsg >16 <=48 sq in |
28 |
27 |
$875.74 |
| A6248 |
Hydrogel drsg gel filler |
13 |
13 |
$0.00 |