| 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 |
5,067 |
4,622 |
$246K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,365 |
1,267 |
$44K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,108 |
1,031 |
$14K |
| A7030 |
Full face mask used with positive airway pressure device, each |
236 |
216 |
$11K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,406 |
1,266 |
$10K |
| A4452 |
Tape, waterproof, per 18 square inches |
586 |
525 |
$8K |
| A6212 |
Foam dressing, wound cover, sterile, pad size 16 sq. in. or less, with any size adhesive border, each dressing |
106 |
89 |
$5K |
| A7037 |
Tubing used with positive airway pressure device |
1,013 |
892 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,362 |
1,183 |
$5K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
595 |
483 |
$4K |
| 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 |
40 |
36 |
$3K |
| A6196 |
Alginate or other fiber gelling dressing, wound cover, sterile, pad size 16 sq. in. or less, each dressing |
16 |
14 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
164 |
145 |
$2K |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
48 |
36 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
73 |
56 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
26 |
25 |
$603.96 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
163 |
147 |
$476.93 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
57 |
51 |
$297.20 |