| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
8,267 |
7,310 |
$227K |
| E0570 |
Nebulizer with compression |
2,866 |
2,579 |
$68K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,695 |
2,258 |
$58K |
| E0431 |
Portable gaseous 02 |
5,793 |
5,151 |
$41K |
| E0601 |
Cont airway pressure device |
1,036 |
915 |
$31K |
| K0001 |
Standard wheelchair |
2,760 |
2,424 |
$27K |
| A5512 |
Multi den insert direct form |
415 |
303 |
$25K |
| A5500 |
Diab shoe for density insert |
399 |
305 |
$21K |
| L3908 |
Who cock-up nonmolde pre ots |
314 |
227 |
$10K |
| E0562 |
Humidifier heated used w pap |
1,201 |
1,080 |
$8K |
| A7031 |
Replacement facemask interfa |
176 |
150 |
$3K |
| A7038 |
Pos airway pressure filter |
1,248 |
1,088 |
$3K |
| B4150 |
Ef complet w/intact nutrient |
14 |
12 |
$2K |
| A7003 |
Nebulizer administration set |
892 |
844 |
$1K |
| A4604 |
Tubing with heating element |
41 |
41 |
$1K |
| A7035 |
Pos airway press headgear |
107 |
97 |
$1K |
| A6402 |
Sterile gauze <= 16 sq in |
46 |
37 |
$709.88 |
| A7030 |
Cpap full face mask |
13 |
13 |
$604.79 |
| K0195 |
Elevating whlchair leg rests |
60 |
51 |
$422.35 |
| A4253 |
Blood glucose/reagent strips |
151 |
135 |
$396.78 |
| E0143 |
Walker folding wheeled w/o s |
12 |
12 |
$199.67 |
| A7046 |
Repl water chamber, pap dev |
18 |
12 |
$107.64 |
| A7037 |
Pos airway pressure tubing |
18 |
12 |
$92.57 |
| A4259 |
Lancets per box |
119 |
107 |
$36.40 |