| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer with compression |
6,250 |
5,909 |
$453K |
| A7005 |
Nondisposable nebulizer set |
5,968 |
5,643 |
$114K |
| T4521 |
Adult size brief/diaper sm |
438 |
242 |
$28K |
| E1088 |
Wheelchair lightweight det a |
187 |
109 |
$27K |
| E1390 |
Oxygen concentrator |
435 |
403 |
$24K |
| E0260 |
Hosp bed semi-electr w/ matt |
276 |
246 |
$19K |
| A7003 |
Nebulizer administration set |
5,889 |
5,498 |
$12K |
| A7015 |
Aerosol mask used w nebulize |
5,415 |
5,117 |
$7K |
| K0003 |
Lightweight wheelchair |
777 |
767 |
$7K |
| E0431 |
Portable gaseous 02 |
422 |
391 |
$5K |
| E0971 |
Wheelchair anti-tipping devi |
778 |
390 |
$850.45 |
| E0961 |
Wheelchair brake extension |
738 |
365 |
$237.78 |