| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,789 |
2,763 |
$196K |
| A4554 |
Disposable underpads |
4,410 |
4,385 |
$143K |
| T4527 |
Adult size pull-on lg |
1,216 |
1,212 |
$139K |
| T4528 |
Adult size pull-on xl |
691 |
686 |
$97K |
| T4535 |
Disposable liner/shield/pad |
1,786 |
1,740 |
$76K |
| T4526 |
Adult size pull-on med |
496 |
476 |
$51K |
| E0601 |
Cont airway pressure device |
692 |
686 |
$35K |
| E0570 |
Nebulizer with compression |
469 |
463 |
$35K |
| A4335 |
Incontinence supply |
6,104 |
6,062 |
$32K |
| E0431 |
Portable gaseous 02 |
1,670 |
1,653 |
$23K |
| K0001 |
Standard wheelchair |
1,338 |
1,336 |
$20K |
| K0003 |
Lightweight wheelchair |
524 |
515 |
$16K |
| E0260 |
Hosp bed semi-electr w/ matt |
624 |
621 |
$13K |
| A7005 |
Nondisposable nebulizer set |
243 |
239 |
$4K |
| B9998 |
Enteral supp not otherwise c |
61 |
50 |
$4K |
| A7038 |
Pos airway pressure filter |
296 |
295 |
$1K |
| A7030 |
Cpap full face mask |
14 |
14 |
$1K |
| A7031 |
Replacement facemask interfa |
29 |
29 |
$990.74 |
| A7015 |
Aerosol mask used w nebulize |
590 |
581 |
$656.53 |
| A7035 |
Pos airway press headgear |
42 |
42 |
$561.65 |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$352.82 |
| K0195 |
Elevating whlchair leg rests |
37 |
37 |
$344.17 |
| A4245 |
Alcohol wipes per box |
62 |
62 |
$207.58 |
| A7037 |
Pos airway pressure tubing |
13 |
13 |
$206.11 |
| A7013 |
Disposable compressor filter |
288 |
284 |
$140.45 |
| A7003 |
Nebulizer administration set |
37 |
36 |
$109.52 |