| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,682 |
1,671 |
$120K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,576 |
1,566 |
$20K |
| K0003 |
Lightweight wheelchair |
432 |
426 |
$16K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
453 |
451 |
$16K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
65 |
63 |
$399.03 |
| A7002 |
Tubing, used with suction pump, each |
13 |
12 |
$114.63 |