| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 11042 |
Debridement, subcutaneous tissue (includes epidermis, dermis, and subcutaneous tissue); first 20 sq cm |
9,367 |
3,404 |
$455K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
4,563 |
2,811 |
$205K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
2,435 |
1,834 |
$143K |
| Q4131 |
Epifix or epicord, per square centimeter |
86 |
43 |
$37K |
| 11045 |
|
483 |
192 |
$28K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
2,426 |
1,254 |
$10K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
2,531 |
1,250 |
$3K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
274 |
114 |
$3K |
| 97597 |
|
36 |
27 |
$1K |
| A6256 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
125 |
77 |
$1K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
85 |
34 |
$1K |
| A6217 |
Gauze, non-impregnated, non-sterile, pad size more than 16 sq. in. but less than or equal to 48 sq. in., without adhesive border, each dressing |
1,526 |
830 |
$257.60 |
| 1036F |
|
191 |
131 |
$0.00 |
| 3074F |
|
40 |
28 |
$0.00 |
| 3075F |
|
18 |
15 |
$0.00 |
| 3079F |
|
33 |
29 |
$0.00 |
| 3078F |
|
18 |
14 |
$0.00 |