| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,043 |
6,002 |
$420K |
| E0570 |
Nebulizer with compression |
2,849 |
2,835 |
$123K |
| E0431 |
Portable gaseous 02 |
4,650 |
4,598 |
$102K |
| K0003 |
Lightweight wheelchair |
1,380 |
1,367 |
$43K |
| E0260 |
Hosp bed semi-electr w/ matt |
818 |
816 |
$33K |
| E0601 |
Cont airway pressure device |
577 |
569 |
$27K |
| A7005 |
Nondisposable nebulizer set |
1,473 |
1,465 |
$21K |
| T4541 |
Large disposable underpad |
245 |
243 |
$11K |
| E0143 |
Walker folding wheeled w/o s |
205 |
204 |
$11K |
| A6530 |
Compression stocking bk18-30 |
148 |
145 |
$5K |
| K0738 |
Portable gas oxygen system |
549 |
540 |
$5K |
| A4670 |
Automatic bp monitor, dial |
38 |
38 |
$2K |
| A7038 |
Pos airway pressure filter |
311 |
307 |
$1K |
| A7030 |
Cpap full face mask |
12 |
12 |
$770.08 |
| A7015 |
Aerosol mask used w nebulize |
587 |
585 |
$651.73 |
| A7037 |
Pos airway pressure tubing |
52 |
52 |
$578.00 |
| A7031 |
Replacement facemask interfa |
25 |
25 |
$564.56 |
| E0973 |
W/ch access det adj armrest |
18 |
12 |
$536.68 |
| E0978 |
W/c acc,saf belt pelv strap |
24 |
24 |
$368.18 |
| A4253 |
Blood glucose/reagent strips |
12 |
12 |
$332.15 |
| A4627 |
Spacer bag/reservoir |
15 |
15 |
$178.99 |
| A7035 |
Pos airway press headgear |
12 |
12 |
$138.92 |
| E0156 |
Walker seat attachment |
12 |
12 |
$107.92 |
| A7003 |
Nebulizer administration set |
23 |
23 |
$6.84 |