| 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 |
888 |
620 |
$9K |
| K0001 |
Standard wheelchair |
1,551 |
996 |
$6K |
| K0002 |
Standard hemi (low seat) wheelchair |
654 |
386 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
189 |
128 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
955 |
610 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
704 |
489 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
87 |
51 |
$641.96 |