| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
8,150 |
4,821 |
$81K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,595 |
2,426 |
$52K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
5,143 |
2,949 |
$50K |
| K0001 |
Standard wheelchair |
8,971 |
5,391 |
$35K |
| K0002 |
Standard hemi (low seat) wheelchair |
2,543 |
1,504 |
$15K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,712 |
1,872 |
$12K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
195 |
110 |
$7K |
| E0570 |
Nebulizer, with compressor |
2,726 |
1,781 |
$3K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
470 |
294 |
$3K |
| K0003 |
Lightweight wheelchair |
439 |
261 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,562 |
895 |
$3K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
384 |
143 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
382 |
244 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
45 |
25 |
$620.34 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
343 |
195 |
$379.64 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
127 |
95 |
$371.37 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
39 |
13 |
$70.20 |