| 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 |
731 |
710 |
$24K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
576 |
564 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
60 |
60 |
$1K |
| E0570 |
Nebulizer, with compressor |
297 |
297 |
$655.11 |
| K0003 |
Lightweight wheelchair |
28 |
28 |
$280.50 |
| E1392 |
Portable oxygen concentrator, rental |
38 |
38 |
$104.62 |