| 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 |
1,017 |
717 |
$33K |
| E0601 |
Continuous positive airway pressure (cpap) device |
122 |
106 |
$10K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
33 |
30 |
$6K |
| K0001 |
Standard wheelchair |
401 |
290 |
$2K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
56 |
52 |
$2K |
| E1392 |
Portable oxygen concentrator, rental |
242 |
179 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
41 |
36 |
$991.22 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
256 |
196 |
$773.97 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
42 |
25 |
$605.29 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
56 |
51 |
$556.97 |
| S8120 |
Oxygen contents, gaseous, 1 unit equals 1 cubic foot |
26 |
12 |
$463.12 |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
22 |
12 |
$295.88 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
13 |
12 |
$217.16 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
31 |
28 |
$145.76 |