| 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 |
3,198 |
2,771 |
$123K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,307 |
1,154 |
$46K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
117 |
68 |
$12K |
| E0601 |
Continuous positive airway pressure (cpap) device |
590 |
508 |
$6K |
| A7030 |
Full face mask used with positive airway pressure device, each |
30 |
24 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
202 |
146 |
$463.22 |
| A6219 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
36 |
31 |
$266.40 |
| A7035 |
Headgear used with positive airway pressure device |
38 |
27 |
$255.46 |
| A7031 |
Face mask interface, replacement for full face mask, each |
14 |
12 |
$219.75 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
29 |
18 |
$107.30 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
34 |
23 |
$52.00 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
46 |
25 |
$50.46 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
15 |
12 |
$46.30 |
| A9279 |
Monitoring feature/device, stand-alone or integrated, any type, includes all accessories, components and electronics, not otherwise classified |
38 |
38 |
$0.00 |