| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
12,399 |
11,299 |
$563K |
| E0601 |
Cont airway pressure device |
2,418 |
2,227 |
$78K |
| E0431 |
Portable gaseous 02 |
5,991 |
5,368 |
$77K |
| A6021 |
Collagen dressing <=16 sq in |
101 |
70 |
$12K |
| A6196 |
Alginate dressing <=16 sq in |
175 |
140 |
$12K |
| E0562 |
Humidifier heated used w pap |
422 |
335 |
$11K |
| A6252 |
Absorpt drg >16 <=48 w/o bdr |
251 |
193 |
$8K |
| A7030 |
Cpap full face mask |
216 |
183 |
$7K |
| A7035 |
Pos airway press headgear |
337 |
302 |
$4K |
| A7038 |
Pos airway pressure filter |
1,575 |
1,423 |
$4K |
| A7037 |
Pos airway pressure tubing |
370 |
341 |
$3K |
| A6010 |
Collagen based wound filler |
12 |
12 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
185 |
157 |
$2K |
| A6266 |
Impreg gauze no h20/sal/yard |
23 |
14 |
$2K |
| A6446 |
Conform band s w>=3" <5"/yd |
90 |
77 |
$1K |
| A7039 |
Filter, non disposable w pap |
242 |
219 |
$1K |
| A6219 |
Gauze <= 16 sq in w/border |
80 |
66 |
$959.02 |
| A7031 |
Replacement facemask interfa |
55 |
40 |
$623.76 |
| A4450 |
Non-waterproof tape |
173 |
159 |
$559.06 |
| E0570 |
Nebulizer with compression |
13 |
12 |
$358.30 |
| A7034 |
Nasal application device |
12 |
12 |
$176.10 |