| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hosp bed semi-electr w/ matt |
350 |
311 |
$6K |
| K0001 |
Standard wheelchair |
378 |
305 |
$3K |
| A4253 |
Blood glucose/reagent strips |
876 |
723 |
$2K |
| E0570 |
Nebulizer with compression |
1,069 |
793 |
$2K |
| E0601 |
Cont airway pressure device |
55 |
49 |
$1K |
| A7030 |
Cpap full face mask |
12 |
12 |
$667.30 |
| J7613 |
Albuterol non-comp unit |
38 |
37 |
$580.25 |
| A7031 |
Replacement facemask interfa |
12 |
12 |
$76.18 |
| A7035 |
Pos airway press headgear |
66 |
55 |
$0.00 |
| A7038 |
Pos airway pressure filter |
77 |
68 |
$0.00 |
| Q0513 |
Disp fee inhal drugs/30 days |
184 |
176 |
$0.00 |
| A7037 |
Pos airway pressure tubing |
67 |
56 |
$0.00 |