| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
2,310 |
1,859 |
$99K |
| E0570 |
Nebulizer with compression |
1,077 |
765 |
$40K |
| E0431 |
Portable gaseous 02 |
1,482 |
1,216 |
$13K |
| E0260 |
Hosp bed semi-electr w/ matt |
496 |
408 |
$10K |
| K0002 |
Stnd hemi (low seat) whlchr |
359 |
316 |
$4K |
| A7005 |
Nondisposable nebulizer set |
386 |
261 |
$4K |
| A7038 |
Pos airway pressure filter |
617 |
382 |
$3K |
| T4524 |
Adult size brief/diaper xl |
16 |
12 |
$3K |
| K0001 |
Standard wheelchair |
125 |
71 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
869 |
484 |
$2K |
| E0601 |
Cont airway pressure device |
64 |
49 |
$1K |
| A4253 |
Blood glucose/reagent strips |
55 |
39 |
$691.05 |
| E0562 |
Humidifier heated used w pap |
148 |
115 |
$635.44 |
| A4259 |
Lancets per box |
56 |
39 |
$104.68 |
| A7037 |
Pos airway pressure tubing |
31 |
29 |
$68.39 |
| A7039 |
Filter, non disposable w pap |
19 |
15 |
$25.11 |