| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| Q4253 |
Zenith amniotic membrane, per square centimeter (add-on, list separately in addition to primary procedure) |
314 |
160 |
$395K |
| 99348 |
|
6,332 |
2,688 |
$163K |
| 15271 |
|
283 |
138 |
$115K |
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
5,757 |
2,438 |
$65K |
| Q4217 |
Woundfix, biowound, woundfix plus, biowound plus, woundfix xplus or biowound xplus, per square centimeter (add-on, list separately in addition to primary procedure) |
25 |
13 |
$52K |
| 99342 |
|
818 |
813 |
$22K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
28 |
27 |
$3K |
| 11000 |
|
665 |
460 |
$2K |
| 11721 |
|
323 |
322 |
$2K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
29 |
29 |
$2K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
31 |
29 |
$2K |
| 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 |
42 |
37 |
$412.97 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
34 |
32 |
$267.71 |