| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
13,192 |
13,123 |
$1.17M |
| E0260 |
Hosp bed semi-electr w/ matt |
5,681 |
5,557 |
$475K |
| E0431 |
Portable gaseous 02 |
13,130 |
13,031 |
$304K |
| K0001 |
Standard wheelchair |
5,443 |
5,399 |
$186K |
| E0185 |
Gel pressure mattress pad |
673 |
640 |
$111K |
| A7003 |
Nebulizer administration set |
28,600 |
27,841 |
$65K |
| E2601 |
Gen w/c cushion wdth < 22 in |
767 |
734 |
$28K |
| A7015 |
Aerosol mask used w nebulize |
28,751 |
27,901 |
$24K |
| K0006 |
Heavy duty wheelchair |
278 |
273 |
$13K |
| K0007 |
Extra heavy duty wheelchair |
220 |
218 |
$11K |
| E0570 |
Nebulizer with compression |
171 |
169 |
$9K |
| E2611 |
Gen use back cush wdth <22in |
76 |
72 |
$6K |
| E0143 |
Walker folding wheeled w/o s |
33 |
31 |
$2K |
| E0443 |
Portable 02 contents, gas |
22 |
22 |
$401.71 |
| E0601 |
Cont airway pressure device |
12 |
12 |
$323.67 |