| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4927 |
Non-sterile gloves |
9,816 |
9,332 |
$82K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,131 |
1,029 |
$51K |
| E0570 |
Nebulizer with compression |
699 |
687 |
$27K |
| E0601 |
Cont airway pressure device |
672 |
642 |
$26K |
| K0001 |
Standard wheelchair |
1,270 |
1,146 |
$24K |
| E1390 |
Oxygen concentrator |
391 |
374 |
$22K |
| A4349 |
Disposable male external cat |
473 |
410 |
$18K |
| E0630 |
Patient lift hydraulic |
232 |
211 |
$6K |
| A4351 |
Straight tip urine catheter |
25 |
25 |
$4K |
| K0738 |
Portable gas oxygen system |
172 |
171 |
$3K |
| K0003 |
Lightweight wheelchair |
99 |
89 |
$2K |
| A7037 |
Pos airway pressure tubing |
119 |
107 |
$2K |
| A4358 |
Urinary leg or abdomen bag |
252 |
229 |
$1K |
| A4357 |
Bedside drainage bag |
181 |
150 |
$1K |
| A7031 |
Replacement facemask interfa |
24 |
24 |
$1K |
| A7030 |
Cpap full face mask |
12 |
12 |
$970.57 |
| A7003 |
Nebulizer administration set |
197 |
192 |
$787.41 |
| A7038 |
Pos airway pressure filter |
137 |
129 |
$610.89 |
| K0195 |
Elevating whlchair leg rests |
50 |
37 |
$511.25 |
| A7015 |
Aerosol mask used w nebulize |
163 |
159 |
$314.94 |
| T5999 |
Supply, nos |
70 |
64 |
$266.92 |
| A4554 |
Disposable underpads |
16 |
12 |
$196.68 |