| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0305 |
Bed side rails, half length |
158 |
158 |
$0.00 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
67 |
67 |
$0.00 |
| E0570 |
Nebulizer, with compressor |
33 |
33 |
$0.00 |
| K0004 |
High strength, lightweight wheelchair |
253 |
252 |
$0.00 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
14 |
14 |
$0.00 |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
175 |
175 |
$0.00 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
202 |
199 |
$0.00 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
137 |
137 |
$0.00 |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
67 |
67 |
$0.00 |
| K0052 |
Swingaway, detachable footrests, replacement only, each |
388 |
385 |
$0.00 |
| K0003 |
Lightweight wheelchair |
44 |
44 |
$0.00 |