| 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 |
3,566 |
3,077 |
$157K |
| K0003 |
Lightweight wheelchair |
3,869 |
3,502 |
$56K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,157 |
1,980 |
$53K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,061 |
911 |
$48K |
| E0570 |
Nebulizer, with compressor |
1,088 |
957 |
$25K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,141 |
1,015 |
$20K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,810 |
2,377 |
$11K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
246 |
115 |
$10K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
352 |
328 |
$5K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
230 |
113 |
$4K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
38 |
31 |
$3K |
| K0006 |
Heavy duty wheelchair |
133 |
120 |
$3K |
| K0001 |
Standard wheelchair |
164 |
148 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
51 |
39 |
$1K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
25 |
25 |
$1K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
14 |
13 |
$291.36 |