| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0003 |
Lightweight wheelchair |
3,067 |
3,039 |
$54K |
| E1390 |
Oxygen concentrator |
706 |
688 |
$49K |
| K0001 |
Standard wheelchair |
2,216 |
2,183 |
$45K |
| T4541 |
Large disposable underpad |
733 |
731 |
$45K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,342 |
1,335 |
$38K |
| E0143 |
Walker folding wheeled w/o s |
853 |
847 |
$29K |
| E0431 |
Portable gaseous 02 |
775 |
756 |
$21K |
| T4526 |
Adult size pull-on med |
198 |
198 |
$13K |
| E0630 |
Patient lift hydraulic |
391 |
383 |
$11K |
| E0443 |
Portable 02 contents, gas |
128 |
112 |
$6K |
| E0163 |
Commode chair with fixed arm |
173 |
166 |
$6K |
| E1038 |
Transport chair pt wt<=300lb |
1,056 |
1,045 |
$6K |
| T4527 |
Adult size pull-on lg |
49 |
49 |
$5K |
| E0570 |
Nebulizer with compression |
747 |
740 |
$4K |
| E0295 |
Hosp bed semi-elect w/o matt |
178 |
176 |
$4K |
| E0156 |
Walker seat attachment |
226 |
226 |
$1K |
| A7003 |
Nebulizer administration set |
189 |
187 |
$357.71 |
| A4253 |
Blood glucose/reagent strips |
40 |
38 |
$244.82 |
| A7015 |
Aerosol mask used w nebulize |
289 |
287 |
$204.94 |
| A7013 |
Disposable compressor filter |
139 |
138 |
$60.57 |
| A4259 |
Lancets per box |
40 |
38 |
$14.10 |