WAYNE HEALTH SERVICES & SUPPLIES, INC.

$95K

Total Medicaid Paid

3,368

Total Claims

2,984

Beneficiaries

21

Codes Billed

2018-01

First Month

2018-12

Last Month

Year	Claims	Total Paid
2018	3,368	$95K

Code	Description	Claims	Beneficiaries	Total Paid
E1390	Oxygen concentrator	702	601	$32K
E0601	Cont airway pressure device	443	415	$14K
E0470	Rad w/o backup non-inv intfc	140	140	$10K
E0431	Portable gaseous 02	528	448	$9K
T4523	Adult size brief/diaper lg	66	51	$5K
E0570	Nebulizer with compression	267	234	$5K
E0260	Hosp bed semi-electr w/ matt	198	192	$4K
K0001	Standard wheelchair	211	198	$3K
E0603	Electric breast pump	30	29	$3K
A4927	Non-sterile gloves	220	178	$2K
A7035	Pos airway press headgear	142	133	$2K
A7030	Cpap full face mask	28	27	$2K
T4527	Adult size pull-on lg	18	13	$791.74
E0562	Humidifier heated used w pap	43	42	$750.50
T4528	Adult size pull-on xl	13	12	$718.83
A7034	Nasal application device	14	13	$500.15
A4452	Waterproof tape	15	13	$419.20
A7038	Pos airway pressure filter	173	140	$321.07
A7037	Pos airway pressure tubing	13	12	$221.40
A7003	Nebulizer administration set	61	54	$95.12
A4554	Disposable underpads	43	39	$0.00

Medicaid Provider Spending