| 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 |
1,230 |
926 |
$80K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
772 |
565 |
$52K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
1,507 |
1,177 |
$22K |
| 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 |
638 |
469 |
$20K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
136 |
108 |
$9K |
| A4452 |
Tape, waterproof, per 18 square inches |
1,009 |
806 |
$9K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,857 |
1,486 |
$8K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
32 |
24 |
$5K |
| 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 |
13 |
13 |
$4K |
| 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 |
14 |
12 |
$3K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
67 |
58 |
$2K |
| A4385 |
Ostomy skin barrier, solid 4 x 4 or equivalent, extended wear, without built-in convexity, each |
44 |
37 |
$1K |
| A6545 |
Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each |
51 |
38 |
$671.25 |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
15 |
13 |
$529.22 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
249 |
214 |
$399.61 |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
51 |
45 |
$314.21 |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
31 |
24 |
$90.00 |
| A5120 |
Skin barrier, wipes or swabs, each |
14 |
12 |
$55.75 |
| A4371 |
Ostomy skin barrier, powder, per oz |
13 |
12 |
$42.36 |