| 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 |
6,815 |
6,799 |
$394K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
719 |
719 |
$78K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
5,052 |
5,045 |
$55K |
| E0570 |
Nebulizer, with compressor |
2,210 |
2,210 |
$51K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,911 |
1,907 |
$50K |
| K0001 |
Standard wheelchair |
1,662 |
1,661 |
$32K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
447 |
440 |
$25K |
| T4541 |
Incontinence product, disposable underpad, large, each |
492 |
475 |
$16K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
103 |
99 |
$12K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
514 |
513 |
$11K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
78 |
75 |
$8K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
598 |
598 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
13 |
13 |
$683.68 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
25 |
24 |
$658.52 |
| E1392 |
Portable oxygen concentrator, rental |
122 |
121 |
$610.44 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
113 |
113 |
$345.61 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
241 |
237 |
$279.28 |
| A7015 |
Aerosol mask, used with dme nebulizer |
138 |
138 |
$216.34 |
| A7014 |
Filter, nondisposable, used with aerosol compressor or ultrasonic generator |
58 |
58 |
$151.12 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
13 |
13 |
$57.40 |