| 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 |
1,765 |
1,001 |
$36K |
| E0570 |
Nebulizer, with compressor |
456 |
278 |
$9K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
512 |
269 |
$6K |
| E1392 |
Portable oxygen concentrator, rental |
395 |
252 |
$4K |
| B4150 |
Enteral formula, nutritionally complete with intact nutrients, includes proteins, fats, carbohydrates, vitamins and minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
176 |
74 |
$3K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
642 |
339 |
$3K |
| K0001 |
Standard wheelchair |
428 |
232 |
$2K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
170 |
125 |
$242.50 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
17 |
12 |
$221.19 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
16 |
15 |
$7.01 |