| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,603 |
7,855 |
$496K |
| E0431 |
Portable gaseous 02 |
5,900 |
5,437 |
$74K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
348 |
300 |
$18K |
| E0601 |
Cont airway pressure device |
743 |
632 |
$17K |
| A7030 |
Cpap full face mask |
305 |
262 |
$15K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
203 |
181 |
$15K |
| A6196 |
Alginate dressing <=16 sq in |
111 |
94 |
$14K |
| E0570 |
Nebulizer with compression |
1,313 |
1,210 |
$12K |
| A6446 |
Conform band s w>=3" <5"/yd |
338 |
308 |
$9K |
| A4452 |
Waterproof tape |
328 |
308 |
$6K |
| A7037 |
Pos airway pressure tubing |
840 |
723 |
$4K |
| A6402 |
Sterile gauze <= 16 sq in |
353 |
311 |
$3K |
| A6266 |
Impreg gauze no h20/sal/yard |
15 |
15 |
$3K |
| A7038 |
Pos airway pressure filter |
1,036 |
892 |
$3K |
| A4450 |
Non-waterproof tape |
720 |
649 |
$3K |
| A6216 |
Non-sterile gauze<=16 sq in |
406 |
360 |
$3K |
| A7031 |
Replacement facemask interfa |
137 |
120 |
$2K |
| A7035 |
Pos airway press headgear |
182 |
165 |
$2K |
| E0562 |
Humidifier heated used w pap |
88 |
84 |
$1K |
| A7039 |
Filter, non disposable w pap |
105 |
100 |
$381.35 |
| A7034 |
Nasal application device |
13 |
13 |
$322.40 |
| A7046 |
Repl water chamber, pap dev |
29 |
27 |
$129.46 |
| A6260 |
Wound cleanser any type/size |
14 |
13 |
$87.36 |
| A6457 |
Tubular dressing |
14 |
12 |
$59.95 |
| A7003 |
Nebulizer administration set |
12 |
12 |
$27.22 |