| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,197 |
4,736 |
$213K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,259 |
3,001 |
$31K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
293 |
236 |
$29K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
120 |
105 |
$10K |
| E0601 |
Continuous positive airway pressure (cpap) device |
349 |
335 |
$8K |
| 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 |
73 |
64 |
$3K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
314 |
254 |
$1K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
95 |
80 |
$1K |
| A4452 |
Tape, waterproof, per 18 square inches |
40 |
37 |
$788.96 |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
19 |
13 |
$533.71 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
32 |
25 |
$71.28 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
17 |
13 |
$53.28 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
22 |
13 |
$23.00 |