| 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 |
8,603 |
7,855 |
$496K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,900 |
5,437 |
$74K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
348 |
300 |
$18K |
| E0601 |
Continuous positive airway pressure (cpap) device |
743 |
632 |
$17K |
| A7030 |
Full face mask used with positive airway pressure device, each |
305 |
262 |
$15K |
| 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 |
203 |
181 |
$15K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
111 |
94 |
$14K |
| E0570 |
Nebulizer, with compressor |
1,313 |
1,210 |
$12K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
338 |
308 |
$9K |
| A4452 |
Tape, waterproof, per 18 square inches |
328 |
308 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
840 |
723 |
$4K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
353 |
311 |
$3K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
15 |
15 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,036 |
892 |
$3K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
720 |
649 |
$3K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
406 |
360 |
$3K |
| A7031 |
Face mask interface, replacement for full face mask, each |
137 |
120 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
182 |
165 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
88 |
84 |
$1K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
105 |
100 |
$381.35 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
13 |
13 |
$322.40 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
29 |
27 |
$129.46 |
| A6260 |
Wound cleansers, any type, any size |
14 |
13 |
$87.36 |
| A6457 |
Tubular dressing with or without elastic, any width, per linear yard |
14 |
12 |
$59.95 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
12 |
12 |
$27.22 |