| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
1,921 |
1,777 |
$308K |
| A4670 |
Automatic bp monitor, dial |
3,438 |
3,186 |
$217K |
| T4541 |
Large disposable underpad |
1,955 |
1,884 |
$134K |
| E0443 |
Portable 02 contents, gas |
1,870 |
1,702 |
$130K |
| T4527 |
Adult size pull-on lg |
801 |
782 |
$86K |
| T4535 |
Disposable liner/shield/pad |
1,193 |
1,170 |
$58K |
| T4528 |
Adult size pull-on xl |
387 |
375 |
$46K |
| T4526 |
Adult size pull-on med |
392 |
385 |
$46K |
| E0143 |
Walker folding wheeled w/o s |
398 |
348 |
$43K |
| E0240 |
Bath/shower chair |
396 |
325 |
$42K |
| E0570 |
Nebulizer with compression |
329 |
281 |
$30K |
| K0001 |
Standard wheelchair |
317 |
316 |
$16K |
| E0156 |
Walker seat attachment |
566 |
491 |
$12K |
| A4927 |
Non-sterile gloves |
571 |
540 |
$8K |
| A7003 |
Nebulizer administration set |
988 |
900 |
$4K |
| E0100 |
Cane adjust/fixed with tip |
80 |
78 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
13 |
12 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
663 |
585 |
$991.67 |
| E0431 |
Portable gaseous 02 |
25 |
25 |
$687.21 |
| E1639 |
Scale, each |
12 |
12 |
$280.08 |