| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
6,528 |
5,950 |
$264K |
| A6010 |
Collagen based wound filler, dry form, sterile, per gram of collagen |
2,555 |
2,359 |
$244K |
| 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 |
2,308 |
2,109 |
$175K |
| A4623 |
Tracheostomy, inner cannula |
1,433 |
1,355 |
$60K |
| A6203 |
Composite dressing, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
4,377 |
3,892 |
$57K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
2,949 |
2,669 |
$51K |
| 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 |
2,929 |
2,437 |
$37K |
| A4452 |
Tape, waterproof, per 18 square inches |
4,049 |
3,527 |
$36K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
607 |
541 |
$33K |
| A7526 |
Tracheostomy tube collar/holder, each |
1,197 |
1,129 |
$31K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
4,688 |
4,087 |
$30K |
| A6199 |
Alginate or other fiber gelling dressing, wound filler, sterile, per 6 inches |
756 |
708 |
$26K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
730 |
632 |
$10K |
| A4333 |
Urinary catheter anchoring device, adhesive skin attachment, each |
2,147 |
1,924 |
$9K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,740 |
1,572 |
$9K |
| A6449 |
Light compression bandage, elastic, knitted/woven, width greater than or equal to three inches and less than five inches, per yard |
247 |
199 |
$8K |
| A6242 |
Hydrogel dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
637 |
568 |
$8K |
| A4314 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way latex with coating (teflon, silicone, silicone elastomer or hydrophilic, etc.) |
2,285 |
2,060 |
$7K |
| A4357 |
Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each |
4,759 |
4,354 |
$7K |
| A4315 |
Insertion tray with drainage bag with indwelling catheter, foley type, two-way, all silicone |
1,077 |
964 |
$3K |
| A5120 |
Skin barrier, wipes or swabs, each |
967 |
868 |
$2K |
| A7521 |
Tracheostomy/laryngectomy tube, cuffed, polyvinylchloride (pvc), silicone or equal, each |
172 |
169 |
$2K |
| A6454 |
Self-adherent bandage, elastic, non-knitted/non-woven, width greater than or equal to three inches and less than five inches, per yard |
86 |
77 |
$2K |
| A6248 |
Hydrogel dressing, wound filler, gel, per fluid ounce |
1,061 |
980 |
$2K |
| A4320 |
Irrigation tray with bulb or piston syringe, any purpose |
180 |
174 |
$2K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
424 |
335 |
$1K |
| A6231 |
Gauze, impregnated, hydrogel, for direct wound contact, sterile, pad size 16 sq. in. or less, each dressing |
96 |
91 |
$1K |
| A4334 |
Urinary catheter anchoring device, leg strap, each |
1,650 |
1,520 |
$1K |
| A6234 |
Hydrocolloid dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
147 |
130 |
$1K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
326 |
270 |
$943.76 |
| A4456 |
Adhesive remover, wipes, any type, each |
624 |
547 |
$862.20 |
| A4358 |
Urinary drainage bag, leg or abdomen, vinyl, with or without tube, with straps, each |
708 |
609 |
$742.23 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
248 |
233 |
$652.72 |
| A4394 |
Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce |
121 |
103 |
$417.64 |
| A5063 |
Ostomy pouch, drainable; for use on barrier with flange (2 piece system), each |
105 |
90 |
$268.85 |
| A4409 |
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each |
14 |
12 |
$201.18 |
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
15 |
12 |
$160.68 |
| A4362 |
Skin barrier; solid, 4 x 4 or equivalent; each |
15 |
12 |
$149.74 |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
27 |
24 |
$131.93 |
| A5131 |
Appliance cleaner, incontinence and ostomy appliances, per 16 oz. |
89 |
82 |
$4.90 |
| A4629 |
Tracheostomy care kit for established tracheostomy |
206 |
206 |
$0.00 |
| A4371 |
Ostomy skin barrier, powder, per oz |
15 |
12 |
$0.00 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
61 |
52 |
$0.00 |