| 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 |
2,818 |
2,541 |
$178K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
323 |
267 |
$39K |
| E0601 |
Continuous positive airway pressure (cpap) device |
705 |
627 |
$24K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,370 |
1,240 |
$19K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
150 |
132 |
$11K |
| A6209 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
105 |
88 |
$6K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
207 |
180 |
$4K |
| 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 |
15 |
12 |
$4K |
| A6021 |
Collagen dressing, sterile, size 16 sq. in. or less, each |
14 |
12 |
$3K |
| A6216 |
Gauze, non-impregnated, non-sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
470 |
432 |
$3K |
| A4452 |
Tape, waterproof, per 18 square inches |
166 |
147 |
$2K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
46 |
41 |
$1K |
| A4450 |
Tape, non-waterproof, per 18 square inches |
342 |
305 |
$975.66 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
137 |
121 |
$724.88 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
82 |
75 |
$292.83 |
| A7037 |
Tubing used with positive airway pressure device |
12 |
12 |
$178.61 |