| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2016 |
Habilitation, residential, waiver; per diem |
4,502 |
151 |
$3.83M |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
12,473 |
11,817 |
$525K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
8,705 |
8,254 |
$279K |
| E0443 |
Portable oxygen contents, gaseous, 1 month's supply = 1 unit |
2,521 |
2,356 |
$110K |
| E0601 |
Continuous positive airway pressure (cpap) device |
904 |
864 |
$30K |
| T2001 |
Non-emergency transportation; patient attendant/escort |
73 |
73 |
$15K |
| T1002 |
Rn services, up to 15 minutes |
111 |
111 |
$7K |
| K0001 |
Standard wheelchair |
487 |
440 |
$6K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
174 |
168 |
$6K |
| E0570 |
Nebulizer, with compressor |
328 |
324 |
$4K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
45 |
43 |
$77.59 |