| 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 |
515 |
496 |
$9K |
| E0570 |
Nebulizer, with compressor |
500 |
496 |
$8K |
| K0001 |
Standard wheelchair |
611 |
597 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
123 |
123 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
311 |
300 |
$806.89 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
63 |
55 |
$365.82 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
16 |
13 |
$34.38 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
16 |
15 |
$29.92 |
| A7015 |
Aerosol mask, used with dme nebulizer |
16 |
13 |
$14.64 |
| A7013 |
Filter, disposable, used with aerosol compressor or ultrasonic generator |
16 |
13 |
$12.34 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
13 |
13 |
$7.83 |