| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
239 |
162 |
$193K |
| K0001 |
Standard wheelchair |
1,317 |
1,301 |
$63K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
413 |
410 |
$55K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
974 |
953 |
$16K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
40 |
38 |
$12K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
55 |
50 |
$5K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
13 |
13 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
50 |
49 |
$2K |
| E0570 |
Nebulizer, with compressor |
15 |
15 |
$2K |
| A7031 |
Face mask interface, replacement for full face mask, each |
37 |
37 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
192 |
190 |
$1K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
51 |
50 |
$979.41 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
15 |
14 |
$729.34 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
12 |
12 |
$550.59 |
| A7035 |
Headgear used with positive airway pressure device |
14 |
14 |
$257.60 |
| A7037 |
Tubing used with positive airway pressure device |
14 |
14 |
$248.41 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
14 |
14 |
$54.96 |
| A7015 |
Aerosol mask, used with dme nebulizer |
14 |
14 |
$18.66 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
14 |
14 |
$7.59 |