| 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 |
3,712 |
3,658 |
$202K |
| K0001 |
Standard wheelchair |
1,932 |
1,914 |
$47K |
| E0601 |
Continuous positive airway pressure (cpap) device |
610 |
607 |
$33K |
| 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 |
1,628 |
1,611 |
$25K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
490 |
483 |
$15K |
| K0003 |
Lightweight wheelchair |
401 |
397 |
$14K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
613 |
600 |
$9K |
| E1392 |
Portable oxygen concentrator, rental |
310 |
308 |
$7K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
199 |
191 |
$7K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
506 |
503 |
$6K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
82 |
82 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
80 |
80 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
211 |
211 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
26 |
26 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
12 |
12 |
$94.48 |