| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0003 |
Lightweight wheelchair |
4,744 |
4,589 |
$302K |
| K0004 |
High strength ltwt whlchr |
2,346 |
2,203 |
$174K |
| E0260 |
Hosp bed semi-electr w/ matt |
2,616 |
2,414 |
$143K |
| E1238 |
Fld ped wc adjstabl w/o seat |
501 |
500 |
$80K |
| E0630 |
Patient lift hydraulic |
1,374 |
1,210 |
$68K |
| K0001 |
Standard wheelchair |
1,362 |
1,310 |
$54K |
| K0195 |
Elevating whlchair leg rests |
6,934 |
6,570 |
$50K |
| E0570 |
Nebulizer with compression |
392 |
386 |
$37K |
| E0277 |
Powered pres-redu air mattrs |
354 |
321 |
$32K |
| E1390 |
Oxygen concentrator |
688 |
655 |
$27K |
| E0143 |
Walker folding wheeled w/o s |
391 |
384 |
$21K |
| E1226 |
Manual fully reclining back |
439 |
428 |
$19K |
| E0163 |
Commode chair with fixed arm |
229 |
218 |
$14K |
| E1224 |
Wheelchair spec size w/ leg |
258 |
253 |
$14K |
| E0265 |
Hosp bed total electr w/ mat |
279 |
269 |
$11K |
| E0971 |
Wheelchair anti-tipping devi |
2,574 |
2,469 |
$9K |
| E0978 |
W/c acc,saf belt pelv strap |
1,772 |
1,696 |
$6K |
| E0431 |
Portable gaseous 02 |
535 |
513 |
$5K |
| E0181 |
Press pad alternating w/ pum |
424 |
362 |
$4K |
| E2601 |
Gen w/c cushion wdth < 22 in |
70 |
65 |
$2K |
| E0443 |
Portable 02 contents, gas |
33 |
28 |
$1K |
| E0966 |
Wheelchair head rest extensi |
24 |
24 |
$118.17 |
| A7003 |
Nebulizer administration set |
55 |
55 |
$113.95 |