| 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 |
1,403 |
1,356 |
$80K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
649 |
616 |
$8K |
| K0003 |
Lightweight wheelchair |
51 |
49 |
$905.23 |
| E0570 |
Nebulizer, with compressor |
13 |
13 |
$674.12 |
| A4335 |
Incontinence supply; miscellaneous |
70 |
61 |
$170.96 |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
12 |
12 |
$127.36 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
20 |
18 |
$29.82 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
19 |
18 |
$15.74 |