| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
6,528 |
5,659 |
$462K |
| A4520 |
Incontinence garment anytype |
1,966 |
1,508 |
$182K |
| E0570 |
Nebulizer with compression |
2,868 |
2,536 |
$67K |
| E0431 |
Portable gaseous 02 |
2,652 |
2,263 |
$51K |
| A4554 |
Disposable underpads |
1,209 |
956 |
$20K |
| A4253 |
Blood glucose/reagent strips |
2,158 |
1,889 |
$11K |
| A5500 |
Diab shoe for density insert |
178 |
82 |
$7K |
| A5512 |
Multi den insert direct form |
174 |
81 |
$7K |
| Q0513 |
Disp fee inhal drugs/30 days |
554 |
536 |
$7K |
| A7003 |
Nebulizer administration set |
1,078 |
957 |
$5K |
| K0001 |
Standard wheelchair |
254 |
211 |
$5K |
| A4259 |
Lancets per box |
1,233 |
1,089 |
$2K |
| J7620 |
Albuterol ipratrop non-comp |
131 |
124 |
$2K |
| E0973 |
W/ch access det adj armrest |
29 |
12 |
$768.46 |
| A7030 |
Cpap full face mask |
12 |
12 |
$558.61 |
| A7037 |
Pos airway pressure tubing |
16 |
15 |
$397.28 |
| A7038 |
Pos airway pressure filter |
15 |
14 |
$324.20 |
| J7613 |
Albuterol non-comp unit |
26 |
24 |
$210.06 |