| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
39,728 |
34,608 |
$5.35M |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
74,346 |
64,163 |
$5.02M |
| A6197 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
24,430 |
20,526 |
$4.20M |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
52,153 |
45,075 |
$3.14M |
| 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 |
68,628 |
59,367 |
$2.53M |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
114,874 |
100,835 |
$1.77M |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
33,892 |
29,955 |
$1.56M |
| 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 |
10,299 |
8,951 |
$1.23M |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
11,560 |
9,944 |
$1.08M |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
32,991 |
28,839 |
$856K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
144,533 |
126,408 |
$795K |
| A4452 |
Tape, waterproof, per 18 square inches |
77,283 |
67,387 |
$791K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
13,359 |
11,610 |
$688K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
15,853 |
13,639 |
$509K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
6,439 |
5,547 |
$458K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
9,075 |
7,692 |
$452K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
7,304 |
6,141 |
$448K |
| A6211 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
1,529 |
1,275 |
$378K |
| 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 |
9,437 |
8,270 |
$376K |
| A6545 |
Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each |
9,826 |
7,691 |
$315K |
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
1,963 |
1,719 |
$314K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
3,934 |
3,227 |
$297K |
| A6022 |
Collagen dressing, sterile, size more than 16 sq. in. but less than or equal to 48 sq. in., each |
1,563 |
1,385 |
$276K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
14,168 |
12,326 |
$226K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
68,777 |
60,240 |
$222K |
| A6207 |
Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
6,803 |
5,936 |
$200K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
15,563 |
13,672 |
$200K |
| A6452 |
High compression bandage, elastic, knitted/woven, load resistance greater than or equal to 1.35 foot pounds at 50% maximum stretch, width greater than or equal to three inches and less than five inches, per yard |
2,564 |
2,076 |
$193K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
5,400 |
4,488 |
$190K |
| A6242 |
Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,154 |
2,013 |
$189K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
5,742 |
4,895 |
$183K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
2,259 |
1,857 |
$171K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
4,931 |
4,209 |
$169K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
2,876 |
2,470 |
$148K |
| A6213 |
Foam dressing, wound cover, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
1,729 |
1,453 |
$141K |
| A6243 |
Hydrogel 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 |
623 |
581 |
$131K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
22,823 |
20,353 |
$122K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
3,042 |
2,679 |
$106K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
5,062 |
4,485 |
$97K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,258 |
2,033 |
$66K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
4,475 |
3,683 |
$64K |
| A5061 |
Ostomy pouch, drainable; with barrier attached, (1 piece), each |
1,351 |
1,103 |
$64K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
16,416 |
14,445 |
$63K |
| A4419 |
Ostomy pouch, closed; for use on barrier with non-locking flange, with filter (2 piece), each |
1,775 |
1,421 |
$63K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
462 |
431 |
$62K |
| A6531 |
Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each |
3,013 |
2,453 |
$62K |
| A6261 |
Wound filler, gel/paste, per fluid ounce, not otherwise specified |
4,014 |
3,486 |
$61K |
| A6583 |
Gradient compression wrap with adjustable straps, below knee, each |
1,392 |
582 |
$59K |
| A4388 |
Ostomy pouch, drainable, with extended wear barrier attached, (1 piece), each |
1,065 |
883 |
$59K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
5,338 |
4,570 |
$58K |
| A6407 |
Packing strips, non-impregnated, sterile, up to 2 inches in width, per linear yard |
2,736 |
2,371 |
$57K |
| A4424 |
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each |
1,082 |
902 |
$53K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
92 |
77 |
$53K |
| A6224 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
1,290 |
1,097 |
$50K |
| A4456 |
Adhesive remover, wipes, any type, each |
9,055 |
7,637 |
$49K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
1,574 |
1,364 |
$48K |
| A6441 |
Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard |
5,011 |
4,223 |
$47K |
| A6456 |
Zinc paste impregnated bandage, non-elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
2,318 |
1,941 |
$44K |
| A5120 |
Skin barrier, wipes or swabs, each |
9,861 |
8,329 |
$41K |
| A5057 |
Ostomy pouch, drainable, with extended wear barrier attached, with built in convexity, with filter, (1 piece), each |
479 |
419 |
$37K |
| A4390 |
Ostomy pouch, drainable, with extended wear barrier attached, with built-in convexity (1 piece), each |
466 |
362 |
$36K |
| A6445 |
Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard |
3,189 |
2,836 |
$34K |
| A6206 |
Contact layer, sterile, 16 sq. in. or less, each dressing |
2,287 |
1,973 |
$34K |
| A6450 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to five inches, per yard |
1,403 |
1,175 |
$32K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
3,566 |
3,077 |
$30K |
| A4371 |
Ostomy skin barrier, powder, per oz |
6,209 |
5,300 |
$20K |
| A6220 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., with any size adhesive border, each dressing |
715 |
597 |
$19K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
1,590 |
1,438 |
$18K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
406 |
352 |
$17K |
| A6203 |
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
512 |
438 |
$17K |
| A5056 |
Ostomy pouch, drainable, with extended wear barrier attached, with filter, (1 piece), each |
292 |
250 |
$16K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
855 |
728 |
$13K |
| A4349 |
Male external catheter, with or without adhesive, disposable, each |
578 |
469 |
$11K |
| A4367 |
Ostomy belt, each |
2,719 |
2,311 |
$10K |
| A4389 |
Ostomy pouch, drainable, with barrier attached, with built-in convexity (1 piece), each |
205 |
161 |
$9K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
118 |
85 |
$8K |
| A6254 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
742 |
654 |
$8K |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
1,537 |
1,259 |
$7K |
| 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 |
111 |
84 |
$7K |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
159 |
151 |
$7K |
| A4217 |
Sterile water/saline, 500 ml |
1,338 |
1,266 |
$7K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
22 |
13 |
$7K |
| A6403 |
Gauze, non-impregnated, sterile, pad size more than 16 sq. in. less than or equal to 48 sq. in., without adhesive border, each dressing |
523 |
467 |
$6K |
| A4369 |
Ostomy skin barrier, liquid (spray, brush, etc.), per oz |
1,478 |
1,256 |
$4K |
| A5121 |
Skin barrier; solid, 6 x 6 or equivalent, each |
46 |
38 |
$4K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
803 |
711 |
$2K |
| A4927 |
Gloves, non-sterile, per 100 |
633 |
556 |
$2K |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
377 |
362 |
$2K |
| A6587 |
Gradient compression wrap with adjustable straps, foot, each |
122 |
61 |
$2K |
| S5199 |
Personal care item, nos, each |
328 |
294 |
$2K |
| A6257 |
Transparent film, sterile, 16 sq. in. or less, each dressing |
121 |
107 |
$1K |
| A4373 |
Ostomy skin barrier, with flange (solid, flexible or accordion), with built-in convexity, any size, each |
40 |
36 |
$1K |
| A4364 |
Adhesive, liquid or equal, any type, per oz |
168 |
142 |
$1K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
194 |
182 |
$1K |
| A4332 |
Lubricant, individual sterile packet, each |
245 |
203 |
$794.11 |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
21 |
13 |
$669.73 |
| A4310 |
Insertion tray without drainage bag and without catheter (accessories only) |
157 |
126 |
$608.29 |
| A4338 |
Indwelling catheter; foley type, two-way latex with coating (teflon, silicone, silicone elastomer, or hydrophilic, etc.), each |
198 |
159 |
$579.28 |
| A6011 |
Collagen based wound filler, gel/paste, per gram of collagen |
17 |
13 |
$467.62 |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
33 |
15 |
$406.63 |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
13 |
12 |
$38.20 |
| W4047 |
|
15 |
13 |
$0.00 |