| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
211 |
209 |
$5K |
| K0001 |
Standard wheelchair |
613 |
579 |
$4K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
87 |
82 |
$4K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
136 |
136 |
$3K |
| B4034 |
Enteral feeding supply kit; syringe fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
77 |
75 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
593 |
561 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
89 |
88 |
$1K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
238 |
238 |
$1K |
| E0570 |
Nebulizer, with compressor |
329 |
301 |
$375.78 |
| E0156 |
Seat attachment, walker |
70 |
70 |
$143.73 |