| 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 |
1,527 |
1,375 |
$30K |
| E0570 |
Nebulizer, with compressor |
2,034 |
1,780 |
$24K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,301 |
1,209 |
$5K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
219 |
198 |
$2K |
| K0003 |
Lightweight wheelchair |
368 |
313 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
802 |
717 |
$800.91 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
611 |
554 |
$611.52 |
| E0601 |
Continuous positive airway pressure (cpap) device |
388 |
359 |
$502.16 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
247 |
218 |
$295.46 |
| A7015 |
Aerosol mask, used with dme nebulizer |
400 |
364 |
$253.17 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
40 |
39 |
$148.38 |
| A7035 |
Headgear used with positive airway pressure device |
102 |
84 |
$93.08 |
| A7037 |
Tubing used with positive airway pressure device |
168 |
140 |
$86.24 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
42 |
36 |
$24.49 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
12 |
12 |
$8.91 |