| 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 |
1,880 |
1,393 |
$127K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
5,493 |
4,224 |
$98K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
840 |
669 |
$93K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
1,761 |
1,342 |
$68K |
| 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 |
381 |
274 |
$59K |
| 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 |
1,914 |
1,431 |
$47K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
1,079 |
820 |
$35K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
455 |
358 |
$20K |
| A4452 |
Tape, waterproof, per 18 square inches |
2,291 |
1,756 |
$19K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
3,002 |
2,423 |
$15K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
863 |
643 |
$15K |
| A7030 |
Full face mask used with positive airway pressure device, each |
350 |
269 |
$14K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
2,867 |
2,245 |
$12K |
| A6251 |
Specialty absorptive dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
504 |
375 |
$8K |
| E0601 |
Continuous positive airway pressure (cpap) device |
621 |
498 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
764 |
595 |
$5K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
897 |
687 |
$5K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
1,500 |
1,139 |
$4K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
1,411 |
1,014 |
$4K |
| E0570 |
Nebulizer, with compressor |
570 |
496 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
944 |
709 |
$2K |
| A6253 |
Specialty absorptive dressing, wound cover, sterile, pad size more than 48 sq. in., without adhesive border, each dressing |
60 |
54 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
212 |
175 |
$2K |
| A6443 |
Conforming bandage, non-elastic, knitted/woven, non-sterile, width greater than or equal to three inches and less than five inches, per yard |
140 |
110 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
177 |
141 |
$1K |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
138 |
111 |
$902.38 |
| A7031 |
Face mask interface, replacement for full face mask, each |
32 |
26 |
$572.74 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
50 |
37 |
$109.20 |
| A5120 |
Skin barrier, wipes or swabs, each |
39 |
31 |
$55.00 |
| A6261 |
Wound filler, gel/paste, per fluid ounce, not otherwise specified |
17 |
13 |
$23.24 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
18 |
12 |
$22.10 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
30 |
24 |
$0.00 |