| 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 |
874 |
861 |
$31K |
| K0001 |
Standard wheelchair |
287 |
283 |
$4K |
| E0570 |
Nebulizer, with compressor |
125 |
125 |
$4K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
406 |
403 |
$3K |
| A4335 |
Incontinence supply; miscellaneous |
104 |
103 |
$577.53 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$163.47 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
41 |
40 |
$124.53 |