| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
5,995 |
4,532 |
$1.21M |
| 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 |
2,974 |
2,216 |
$1.16M |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
2,975 |
2,345 |
$948K |
| 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 |
7,147 |
5,621 |
$666K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
6,386 |
5,248 |
$619K |
| 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 |
1,358 |
1,133 |
$529K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
2,139 |
1,717 |
$485K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
2,276 |
1,781 |
$361K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
3,317 |
2,942 |
$277K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
2,258 |
2,004 |
$275K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
6,943 |
5,671 |
$247K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,628 |
1,338 |
$215K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
1,583 |
1,422 |
$207K |
| A4452 |
Tape, waterproof, per 18 square inches |
10,392 |
8,471 |
$206K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
1,883 |
1,565 |
$186K |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
1,761 |
1,618 |
$170K |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
4,644 |
4,173 |
$132K |
| 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 |
2,009 |
1,679 |
$123K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
7,861 |
6,414 |
$122K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
1,795 |
1,445 |
$105K |
| A4353 |
Intermittent urinary catheter, with insertion supplies |
152 |
131 |
$94K |
| A4456 |
Adhesive remover, wipes, any type, each |
5,107 |
4,569 |
$88K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
876 |
721 |
$79K |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
1,563 |
1,385 |
$77K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
2,054 |
1,728 |
$71K |
| 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 |
270 |
197 |
$69K |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
895 |
803 |
$66K |
| A4425 |
Ostomy pouch, drainable; for use on barrier with non-locking flange, with filter (2 piece system), each |
1,069 |
961 |
$63K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
2,409 |
1,985 |
$61K |
| A4927 |
Gloves, non-sterile, per 100 |
3,452 |
2,935 |
$56K |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
955 |
830 |
$49K |
| A5120 |
Skin barrier, wipes or swabs, each |
7,673 |
6,634 |
$48K |
| A6207 |
Contact layer, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
509 |
411 |
$48K |
| T4525 |
Adult sized disposable incontinence product, protective underwear/pull-on, small size, each |
287 |
267 |
$34K |
| T4531 |
Pediatric sized disposable incontinence product, protective underwear/pull-on, small/medium size, each |
233 |
157 |
$24K |
| A4407 |
Ostomy skin barrier, with flange (solid, flexible, or accordion), extended wear, with built-in convexity, 4 x 4 inches or smaller, each |
163 |
145 |
$23K |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
1,922 |
1,731 |
$23K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
1,834 |
1,648 |
$17K |
| A6260 |
Wound cleansers, any type, any size |
2,862 |
2,220 |
$17K |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
625 |
491 |
$15K |
| A6441 |
Padding bandage, non-elastic, non-woven/non-knitted, width greater than or equal to three inches and less than five inches, per yard |
587 |
477 |
$13K |
| T4541 |
Incontinence product, disposable underpad, large, each |
496 |
422 |
$12K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
202 |
155 |
$11K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
506 |
427 |
$10K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,152 |
842 |
$9K |
| A6258 |
Transparent film, sterile, more than 16 sq. in. but less than or equal to 48 sq. in., each dressing |
78 |
67 |
$9K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
2,277 |
1,841 |
$8K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
78 |
58 |
$8K |
| A4432 |
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each |
167 |
152 |
$8K |
| A4371 |
Ostomy skin barrier, powder, per oz |
2,621 |
2,354 |
$6K |
| A4367 |
Ostomy belt, each |
724 |
652 |
$5K |
| A6445 |
Conforming bandage, non-elastic, knitted/woven, sterile, width less than three inches, per yard |
132 |
115 |
$3K |
| A4402 |
Lubricant, per ounce |
578 |
522 |
$3K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
28 |
24 |
$2K |
| T4530 |
Pediatric sized disposable incontinence product, brief/diaper, large size, each |
19 |
12 |
$2K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
16 |
15 |
$2K |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
52 |
39 |
$1K |
| A4332 |
Lubricant, individual sterile packet, each |
156 |
138 |
$1K |
| A6453 |
Self-adherent bandage, elastic, non-knitted/non-woven, width less than three inches, per yard |
21 |
14 |
$530.20 |