| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Cont airway pressure device |
1,397 |
1,373 |
$47K |
| E0570 |
Nebulizer with compression |
6,337 |
6,317 |
$37K |
| K0004 |
High strength ltwt whlchr |
228 |
227 |
$6K |
| L3807 |
Whfo w/o joints pre cst |
59 |
51 |
$6K |
| A7005 |
Nondisposable nebulizer set |
475 |
475 |
$3K |
| E0562 |
Humidifier heated used w pap |
121 |
118 |
$2K |
| A7038 |
Pos airway pressure filter |
283 |
277 |
$1K |
| K0195 |
Elevating whlchair leg rests |
250 |
249 |
$1K |
| A4253 |
Blood glucose/reagent strips |
24 |
24 |
$514.93 |
| A7030 |
Cpap full face mask |
12 |
12 |
$472.84 |
| E0114 |
Crutch underarm pair no wood |
13 |
13 |
$361.73 |
| E0261 |
Hosp bed semi-electr w/o mat |
24 |
24 |
$300.50 |
| A7031 |
Replacement facemask interfa |
12 |
12 |
$290.50 |
| A7037 |
Pos airway pressure tubing |
32 |
32 |
$241.78 |
| A7035 |
Pos airway press headgear |
24 |
24 |
$210.66 |
| A4259 |
Lancets per box |
12 |
12 |
$35.12 |