| 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 |
2,502 |
2,428 |
$40K |
| K0004 |
High strength, lightweight wheelchair |
1,461 |
1,417 |
$24K |
| K0003 |
Lightweight wheelchair |
914 |
879 |
$9K |
| E0601 |
Continuous positive airway pressure (cpap) device |
479 |
459 |
$5K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
305 |
304 |
$4K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,205 |
1,165 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
243 |
239 |
$4K |
| K0002 |
Standard hemi (low seat) wheelchair |
315 |
311 |
$1K |
| K0001 |
Standard wheelchair |
176 |
175 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
40 |
38 |
$788.87 |
| A7035 |
Headgear used with positive airway pressure device |
250 |
245 |
$772.81 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
166 |
164 |
$753.86 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
313 |
306 |
$648.50 |
| E1392 |
Portable oxygen concentrator, rental |
60 |
60 |
$448.19 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
13 |
13 |
$182.94 |
| A7037 |
Tubing used with positive airway pressure device |
67 |
66 |
$147.21 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
12 |
12 |
$103.04 |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
13 |
12 |
$30.48 |
| E0570 |
Nebulizer, with compressor |
27 |
25 |
$15.27 |
| A7030 |
Full face mask used with positive airway pressure device, each |
12 |
12 |
$0.00 |