| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,837 |
1,492 |
$61K |
| A4520 |
Incontinence garment anytype |
751 |
316 |
$21K |
| B4100 |
Food thickener oral |
97 |
85 |
$11K |
| T4535 |
Disposable liner/shield/pad |
196 |
172 |
$9K |
| B4152 |
Ef calorie dense>/=1.5kcal |
72 |
50 |
$7K |
| E0431 |
Portable gaseous 02 |
723 |
563 |
$5K |
| A4930 |
Sterile, gloves per pair |
301 |
283 |
$5K |
| T4537 |
Reusable underpad bed size |
181 |
174 |
$4K |
| B4150 |
Ef complet w/intact nutrient |
60 |
38 |
$3K |
| A6250 |
Skin seal protect moisturizr |
207 |
178 |
$2K |
| A7038 |
Pos airway pressure filter |
622 |
604 |
$1K |
| E0570 |
Nebulizer with compression |
188 |
125 |
$768.53 |
| A7035 |
Pos airway press headgear |
39 |
39 |
$744.26 |
| K0001 |
Standard wheelchair |
91 |
62 |
$510.63 |
| E0601 |
Cont airway pressure device |
12 |
12 |
$477.31 |
| A7015 |
Aerosol mask used w nebulize |
54 |
53 |
$202.13 |
| A7046 |
Repl water chamber, pap dev |
15 |
13 |
$182.37 |
| A7013 |
Disposable compressor filter |
54 |
53 |
$37.22 |