| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
4,240 |
3,639 |
$189K |
| E0601 |
Cont airway pressure device |
1,338 |
1,182 |
$40K |
| E0570 |
Nebulizer with compression |
1,125 |
1,052 |
$27K |
| A6196 |
Alginate dressing <=16 sq in |
253 |
216 |
$25K |
| E0431 |
Portable gaseous 02 |
2,584 |
2,206 |
$23K |
| E2402 |
Neg press wound therapy pump |
63 |
51 |
$10K |
| E0562 |
Humidifier heated used w pap |
492 |
465 |
$9K |
| A6266 |
Impreg gauze no h20/sal/yard |
84 |
70 |
$8K |
| A6212 |
Foam drg <=16 sq in w/border |
117 |
104 |
$7K |
| A7030 |
Cpap full face mask |
126 |
113 |
$6K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
121 |
110 |
$6K |
| A6402 |
Sterile gauze <= 16 sq in |
436 |
401 |
$3K |
| A6209 |
Foam drsg <=16 sq in w/o bdr |
48 |
42 |
$3K |
| A7037 |
Pos airway pressure tubing |
592 |
524 |
$3K |
| A7038 |
Pos airway pressure filter |
838 |
734 |
$3K |
| A6021 |
Collagen dressing <=16 sq in |
16 |
14 |
$2K |
| A6550 |
Neg pres wound ther drsg set |
18 |
12 |
$2K |
| A6446 |
Conform band s w>=3" <5"/yd |
97 |
87 |
$1K |
| A7031 |
Replacement facemask interfa |
42 |
39 |
$702.68 |
| A6452 |
High compres band w>=3"<5"yd |
12 |
12 |
$688.65 |
| A7035 |
Pos airway press headgear |
51 |
49 |
$515.23 |
| A7000 |
Disposable canister for pump |
18 |
12 |
$464.50 |
| A4452 |
Waterproof tape |
44 |
44 |
$462.76 |
| A6222 |
Gauze <=16 in no w/sal w/o b |
13 |
12 |
$262.66 |
| A4450 |
Non-waterproof tape |
118 |
109 |
$258.24 |
| A7003 |
Nebulizer administration set |
27 |
24 |
$51.79 |
| A7039 |
Filter, non disposable w pap |
13 |
13 |
$41.34 |