| 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 |
3,875 |
3,479 |
$109K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
548 |
487 |
$36K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,131 |
1,966 |
$13K |
| K0003 |
Lightweight wheelchair |
544 |
456 |
$5K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
227 |
215 |
$3K |
| K0001 |
Standard wheelchair |
329 |
290 |
$3K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
115 |
99 |
$3K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
34 |
32 |
$509.15 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
148 |
131 |
$124.74 |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
16 |
12 |
$4.46 |