| Code | Description | Claims | Bene. Records | Total Paid |
| E0570 |
Nebulizer, with compressor |
1,641 |
1,587 |
$131K |
| K0001 |
Standard wheelchair |
309 |
288 |
$2K |
| K0003 |
Lightweight wheelchair |
141 |
138 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
328 |
324 |
$489.55 |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
12 |
12 |
$212.46 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
326 |
322 |
$143.91 |