| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
589 |
505 |
$18K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
83 |
66 |
$1K |
| A7031 |
Face mask interface, replacement for full face mask, each |
90 |
74 |
$802.58 |
| E0601 |
Continuous positive airway pressure (cpap) device |
48 |
45 |
$685.92 |
| A7030 |
Full face mask used with positive airway pressure device, each |
13 |
13 |
$658.53 |
| K0001 |
Standard wheelchair |
30 |
24 |
$514.28 |
| A7037 |
Tubing used with positive airway pressure device |
30 |
29 |
$332.02 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
153 |
133 |
$296.09 |
| K0003 |
Lightweight wheelchair |
101 |
92 |
$264.75 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
69 |
52 |
$65.09 |