| 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 |
5,505 |
4,742 |
$212K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,654 |
1,465 |
$53K |
| A6266 |
Gauze, impregnated, other than water, normal saline, or zinc paste, sterile, any width, per linear yard |
226 |
180 |
$33K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,926 |
2,438 |
$23K |
| 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 |
82 |
69 |
$7K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
461 |
419 |
$6K |
| A7037 |
Tubing used with positive airway pressure device |
563 |
501 |
$4K |
| A6222 |
Gauze, impregnated with other than water, normal saline, or hydrogel, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
87 |
73 |
$4K |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
344 |
281 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
922 |
772 |
$2K |
| E0570 |
Nebulizer, with compressor |
265 |
206 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
34 |
28 |
$949.98 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
97 |
91 |
$836.14 |
| E1392 |
Portable oxygen concentrator, rental |
39 |
37 |
$802.36 |
| A7035 |
Headgear used with positive airway pressure device |
62 |
54 |
$625.75 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
16 |
12 |
$505.29 |
| A7031 |
Face mask interface, replacement for full face mask, each |
12 |
12 |
$204.12 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
16 |
13 |
$198.39 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
43 |
40 |
$186.42 |
| A4450 |
Tape, non-waterproof, per 18 square inches |
30 |
24 |
$150.06 |
| K0001 |
Standard wheelchair |
16 |
12 |
$135.99 |