| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hosp bed semi-electr w/ matt |
8,150 |
4,821 |
$81K |
| E1390 |
Oxygen concentrator |
3,595 |
2,426 |
$52K |
| E0250 |
Hosp bed fixed ht w/ mattres |
5,143 |
2,949 |
$50K |
| K0001 |
Standard wheelchair |
8,971 |
5,391 |
$35K |
| K0002 |
Stnd hemi (low seat) whlchr |
2,543 |
1,504 |
$15K |
| E0431 |
Portable gaseous 02 |
2,712 |
1,872 |
$12K |
| E2611 |
Gen use back cush wdth <22in |
195 |
110 |
$7K |
| E0570 |
Nebulizer with compression |
2,726 |
1,781 |
$3K |
| E0255 |
Hospital bed var ht w/ mattr |
470 |
294 |
$3K |
| K0003 |
Lightweight wheelchair |
439 |
261 |
$3K |
| K0195 |
Elevating whlchair leg rests |
1,562 |
895 |
$3K |
| E0951 |
Loop heel |
384 |
143 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
382 |
244 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
45 |
25 |
$620.34 |
| E0181 |
Press pad alternating w/ pum |
343 |
195 |
$379.64 |
| E0261 |
Hosp bed semi-electr w/o mat |
127 |
95 |
$371.37 |
| E0971 |
Wheelchair anti-tipping devi |
39 |
13 |
$70.20 |