| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6010 |
Collagen based wound filler |
12,968 |
11,550 |
$1.26M |
| A6196 |
Alginate dressing <=16 sq in |
31,232 |
28,232 |
$905K |
| A6023 |
Collagen dressing >48 sq in |
521 |
437 |
$689K |
| A6021 |
Collagen dressing <=16 sq in |
8,551 |
7,708 |
$583K |
| A6212 |
Foam drg <=16 sq in w/border |
28,402 |
25,524 |
$512K |
| A6199 |
Alginate drsg wound filler |
6,177 |
5,502 |
$250K |
| A6197 |
Alginate drsg >16 <=48 sq in |
3,004 |
2,684 |
$179K |
| A6446 |
Conform band s w>=3" <5"/yd |
25,211 |
22,555 |
$151K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
11,854 |
10,645 |
$151K |
| A6253 |
Absorpt drg > 48 sq in w/o b |
3,122 |
2,768 |
$91K |
| A6198 |
Alginate dressing > 48 sq in |
821 |
724 |
$89K |
| A6220 |
Gauze >16 <=48 sq in w/bordr |
9,844 |
9,039 |
$83K |
| A6222 |
Gauze <=16 in no w/sal w/o b |
10,296 |
9,357 |
$74K |
| A6219 |
Gauze <= 16 sq in w/border |
18,651 |
17,036 |
$62K |
| A6213 |
Foam drg >16<=48 sq in w/bdr |
2,281 |
1,980 |
$54K |
| A4450 |
Non-waterproof tape |
24,989 |
22,514 |
$48K |
| A6231 |
Hydrogel dsg<=16 sq in |
2,516 |
2,255 |
$38K |
| A6223 |
Gauze >16<=48 no w/sal w/o b |
2,905 |
2,663 |
$27K |
| A6214 |
Foam drg > 48 sq in w/border |
917 |
804 |
$20K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
1,049 |
957 |
$20K |
| A6203 |
Composite drsg <= 16 sq in |
1,895 |
1,743 |
$15K |
| A6450 |
Lt compres band >=5"/yd |
1,787 |
1,575 |
$13K |
| A4623 |
Tracheostomy inner cannula |
303 |
303 |
$11K |
| A6248 |
Hydrogel drsg gel filler |
629 |
576 |
$8K |
| A6251 |
Absorpt drg <=16 sq in w/o b |
658 |
594 |
$8K |
| A7526 |
Tracheostomy tube collar |
227 |
227 |
$4K |
| A6266 |
Impreg gauze no h20/sal/yard |
927 |
852 |
$4K |
| A6456 |
Zinc paste band w >=3"<5"/yd |
531 |
453 |
$4K |
| A6449 |
Lt compres band >=3" <5"/yd |
659 |
586 |
$4K |
| A6234 |
Hydrocolld drg <=16 w/o bdr |
259 |
231 |
$3K |
| A6237 |
Hydrocolld drg <=16 in w/bdr |
224 |
196 |
$2K |
| A4629 |
Tracheostomy care kit |
85 |
85 |
$2K |
| A4452 |
Waterproof tape |
640 |
604 |
$1K |
| A4385 |
Ost skn barrier sld ext wear |
207 |
205 |
$1K |
| A7521 |
Trach/laryn tube cuffed |
81 |
81 |
$1K |
| A4314 |
Cath w/drainage 2-way latex |
515 |
505 |
$907.25 |
| A4333 |
Urinary cath anchor device |
239 |
234 |
$865.87 |
| A6221 |
Gauze > 48 sq in w/border |
165 |
153 |
$830.25 |
| A4456 |
Adhesive remover, wipes |
250 |
248 |
$479.96 |
| A6455 |
Self-adher band >=5"/yd |
172 |
162 |
$437.82 |
| A6454 |
Self-adher band w>=3" <5"/yd |
198 |
161 |
$357.44 |
| A5120 |
Skin barrier, wipe or swab |
314 |
312 |
$346.88 |
| A6457 |
Tubular dressing |
253 |
213 |
$184.00 |
| A6407 |
Packing strips, non-impreg |
44 |
41 |
$172.93 |
| A4394 |
Ostomy pouch liq deodorant |
220 |
219 |
$155.32 |
| A4357 |
Bedside drainage bag |
197 |
192 |
$142.71 |
| A5063 |
Drain ostomy pouch w/flange |
13 |
13 |
$109.10 |
| A4406 |
Pectin based ostomy paste |
203 |
202 |
$50.03 |
| A4320 |
Irrigation tray |
27 |
26 |
$48.96 |
| A4358 |
Urinary leg or abdomen bag |
31 |
29 |
$48.77 |
| A4371 |
Skin barrier powder per oz |
214 |
213 |
$38.55 |
| A4334 |
Urinary cath leg strap |
113 |
106 |
$37.39 |
| A6443 |
Conform band n/s w>=3"<5"/yd |
30 |
28 |
$3.65 |