| 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 |
1,871 |
1,824 |
$66K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
498 |
497 |
$16K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
761 |
740 |
$5K |
| E0601 |
Continuous positive airway pressure (cpap) device |
127 |
120 |
$5K |
| A7030 |
Full face mask used with positive airway pressure device, each |
43 |
40 |
$2K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
156 |
145 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
213 |
207 |
$737.10 |
| A7037 |
Tubing used with positive airway pressure device |
78 |
75 |
$612.03 |
| E2374 |
Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only |
151 |
149 |
$535.30 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$254.82 |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
91 |
63 |
$232.07 |
| K0001 |
Standard wheelchair |
41 |
41 |
$183.21 |
| A7035 |
Headgear used with positive airway pressure device |
12 |
12 |
$69.73 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
48 |
25 |
$16.06 |