| 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 |
2,310 |
1,859 |
$99K |
| E0570 |
Nebulizer, with compressor |
1,077 |
765 |
$40K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,482 |
1,216 |
$13K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
496 |
408 |
$10K |
| K0002 |
Standard hemi (low seat) wheelchair |
359 |
316 |
$4K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
386 |
261 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
617 |
382 |
$3K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
16 |
12 |
$3K |
| K0001 |
Standard wheelchair |
125 |
71 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
869 |
484 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
64 |
49 |
$1K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
55 |
39 |
$691.05 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
148 |
115 |
$635.44 |
| A4259 |
Lancets, per box of 100 |
56 |
39 |
$104.68 |
| A7037 |
Tubing used with positive airway pressure device |
31 |
29 |
$68.39 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
19 |
15 |
$25.11 |