| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6023 |
Collagen dressing >48 sq in |
1,228 |
1,066 |
$990K |
| A6010 |
Collagen based wound filler |
9,291 |
8,458 |
$758K |
| A6021 |
Collagen dressing <=16 sq in |
14,237 |
12,978 |
$673K |
| A6196 |
Alginate dressing <=16 sq in |
21,386 |
19,182 |
$527K |
| A6197 |
Alginate drsg >16 <=48 sq in |
7,485 |
6,747 |
$441K |
| A6212 |
Foam drg <=16 sq in w/border |
8,741 |
7,889 |
$215K |
| A6266 |
Impreg gauze no h20/sal/yard |
5,073 |
4,573 |
$75K |
| A6199 |
Alginate drsg wound filler |
2,236 |
2,015 |
$45K |
| A6446 |
Conform band s w>=3" <5"/yd |
2,831 |
2,572 |
$40K |
| A6237 |
Hydrocolld drg <=16 in w/bdr |
2,492 |
2,316 |
$34K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
4,274 |
3,923 |
$30K |
| A4452 |
Waterproof tape |
8,010 |
7,261 |
$27K |
| A6011 |
Collagen gel/paste wound fil |
1,471 |
1,355 |
$26K |
| A6402 |
Sterile gauze <= 16 sq in |
395 |
296 |
$23K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
1,997 |
1,834 |
$23K |
| A6219 |
Gauze <= 16 sq in w/border |
10,323 |
9,477 |
$22K |
| A6248 |
Hydrogel drsg gel filler |
2,135 |
1,965 |
$21K |
| A6210 |
Foam drg >16<=48 sq in w/o b |
285 |
255 |
$17K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
826 |
750 |
$12K |
| A6240 |
Hydrocolld drg filler paste |
2,225 |
2,057 |
$12K |
| A6220 |
Gauze >16 <=48 sq in w/bordr |
1,155 |
1,091 |
$11K |
| A6449 |
Lt compres band >=3" <5"/yd |
793 |
727 |
$10K |
| A6198 |
Alginate dressing > 48 sq in |
75 |
71 |
$7K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
277 |
250 |
$5K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
245 |
220 |
$4K |
| A6203 |
Composite drsg <= 16 sq in |
370 |
355 |
$3K |
| A6242 |
Hydrogel drg <=16 in w/o bdr |
204 |
190 |
$3K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
299 |
268 |
$2K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
174 |
169 |
$978.85 |
| A6238 |
Hydrocolld drg >16<=48 w/bdr |
13 |
12 |
$774.86 |
| A4357 |
Bedside drainage bag |
501 |
458 |
$669.50 |
| A6454 |
Self-adher band w>=3" <5"/yd |
161 |
137 |
$590.44 |
| A6231 |
Hydrogel dsg<=16 sq in |
15 |
13 |
$474.30 |
| A4338 |
Indwelling catheter latex |
455 |
417 |
$352.41 |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
41 |
39 |
$347.53 |
| A6261 |
Wound filler gel/paste /oz |
102 |
94 |
$279.71 |
| A6235 |
Hydrocolld drg >16<=48 w/o b |
51 |
49 |
$243.31 |
| A4310 |
Insert tray w/o bag/cath |
491 |
451 |
$221.73 |
| A6204 |
Composite drsg >16<=48 sq in |
50 |
50 |
$198.06 |
| A4450 |
Non-waterproof tape |
164 |
142 |
$62.69 |
| A4333 |
Urinary cath anchor device |
81 |
79 |
$54.92 |
| A6441 |
Pad band w>=3" <5"/yd |
14 |
13 |
$46.42 |
| A6457 |
Tubular dressing |
30 |
28 |
$28.00 |
| A4358 |
Urinary leg or abdomen bag |
36 |
32 |
$7.24 |