| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
289 |
284 |
$10K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
122 |
121 |
$8K |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
55 |
55 |
$8K |
| A7027 |
Combination oral/nasal mask, used with continuous positive airway pressure device, each |
44 |
44 |
$4K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
120 |
118 |
$2K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
123 |
122 |
$1K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
86 |
66 |
$539.35 |
| A4452 |
Tape, waterproof, per 18 square inches |
66 |
66 |
$469.50 |
| A7035 |
Headgear used with positive airway pressure device |
28 |
28 |
$363.60 |
| A7037 |
Tubing used with positive airway pressure device |
28 |
28 |
$246.45 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
41 |
41 |
$77.40 |