| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer, with compressor |
6,250 |
5,909 |
$453K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
5,968 |
5,643 |
$114K |
| T4521 |
Adult sized disposable incontinence product, brief/diaper, small, each |
438 |
242 |
$28K |
| E1088 |
High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests |
187 |
109 |
$27K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
435 |
403 |
$24K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
276 |
246 |
$19K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
5,889 |
5,498 |
$12K |
| A7015 |
Aerosol mask, used with dme nebulizer |
5,415 |
5,117 |
$7K |
| K0003 |
Lightweight wheelchair |
777 |
767 |
$7K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
422 |
391 |
$5K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
778 |
390 |
$850.45 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
738 |
365 |
$237.78 |