| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6244 |
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
2,215 |
2,081 |
$1.87M |
| A6211 |
Foam dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
870 |
860 |
$746K |
| A6236 |
Hydrocolloid dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
1,536 |
1,449 |
$623K |
| A6247 |
Hydrogel dressing, wound cover, sterile, pad size more than 48 sq. in., with any size adhesive border, each dressing |
967 |
937 |
$534K |
| 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 |
633 |
621 |
$367K |
| 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 |
1,007 |
967 |
$186K |
| A6198 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size more than 48 sq. in., each dressing |
821 |
776 |
$174K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
108 |
105 |
$131K |
| L1005 |
Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment |
26 |
25 |
$53K |
| 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 |
82 |
81 |
$22K |
| A6259 |
Transparent film, sterile, more than 48 sq. in., each dressing |
461 |
448 |
$22K |
| A6240 |
Hydrocolloid dressing, wound filler, paste, sterile, per ounce |
48 |
47 |
$8K |
| A4452 |
Tape, waterproof, per 18 square inches |
176 |
171 |
$7K |
| A6233 |
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size more than 48 sq. in., each dressing |
35 |
35 |
$6K |
| A4455 |
Adhesive remover or solvent (for tape, cement or other adhesive), per ounce |
60 |
60 |
$3K |
| A6246 |
Hydrogel 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 |
13 |
13 |
$3K |
| A4217 |
Sterile water/saline, 500 ml |
153 |
140 |
$2K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
12 |
12 |
$734.40 |