| 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 |
2,233 |
2,201 |
$274K |
| 99503 |
|
2,210 |
1,614 |
$220K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,101 |
2,068 |
$44K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
103 |
103 |
$27K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
489 |
489 |
$26K |
| 94799 |
|
88 |
88 |
$7K |
| K0001 |
Standard wheelchair |
422 |
419 |
$4K |
| A9284 |
Spirometer, non-electronic, includes all accessories |
14 |
14 |
$980.00 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
13 |
13 |
$548.12 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
13 |
13 |
$221.36 |