| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2038 |
Community transition, waiver; per service |
270 |
163 |
$313K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
198 |
193 |
$17K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
197 |
192 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
147 |
146 |
$664.94 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$203.07 |