| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
420 |
331 |
$12K |
| B4035 |
Enteral feed supp pump per d |
38 |
18 |
$4K |
| K0738 |
Portable gas oxygen system |
231 |
185 |
$1K |
| E0570 |
Nebulizer with compression |
48 |
44 |
$673.92 |
| E0260 |
Hosp bed semi-electr w/ matt |
21 |
17 |
$671.99 |
| E0431 |
Portable gaseous 02 |
42 |
36 |
$440.19 |
| A6402 |
Sterile gauze <= 16 sq in |
22 |
14 |
$283.97 |
| E0143 |
Walker folding wheeled w/o s |
18 |
14 |
$225.28 |
| E0601 |
Cont airway pressure device |
20 |
18 |
$223.72 |
| A7000 |
Disposable canister for pump |
17 |
13 |
$128.42 |
| A4213 |
20+ cc syringe only |
21 |
19 |
$75.12 |
| K0001 |
Standard wheelchair |
22 |
15 |
$69.33 |
| A7002 |
Tubing used w suction pump |
18 |
13 |
$67.30 |
| B9998 |
Enteral supp not otherwise c |
24 |
12 |
$66.82 |