| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0001 |
Standard wheelchair |
854 |
822 |
$11K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
326 |
325 |
$7K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
294 |
293 |
$1K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
143 |
136 |
$1K |
| K0003 |
Lightweight wheelchair |
15 |
15 |
$571.40 |
| E0570 |
Nebulizer, with compressor |
37 |
37 |
$216.21 |