| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,914 |
1,509 |
$63K |
| E0431 |
Portable gaseous 02 |
549 |
484 |
$44K |
| E0601 |
Cont airway pressure device |
1,686 |
1,423 |
$39K |
| K0001 |
Standard wheelchair |
4,268 |
2,885 |
$24K |
| E0562 |
Humidifier heated used w pap |
892 |
811 |
$17K |
| E0250 |
Hosp bed fixed ht w/ mattres |
1,520 |
904 |
$14K |
| E0260 |
Hosp bed semi-electr w/ matt |
339 |
208 |
$5K |
| E0570 |
Nebulizer with compression |
401 |
315 |
$5K |
| A4253 |
Blood glucose/reagent strips |
782 |
560 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
72 |
62 |
$2K |
| K0195 |
Elevating whlchair leg rests |
875 |
593 |
$919.38 |
| E0630 |
Patient lift hydraulic |
91 |
51 |
$479.00 |
| E0163 |
Commode chair with fixed arm |
29 |
25 |
$286.08 |
| A4259 |
Lancets per box |
298 |
210 |
$133.71 |
| E1392 |
Portable oxygen concentrator |
352 |
239 |
$89.11 |