| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
918 |
354 |
$114K |
| E0261 |
Hosp bed semi-electr w/o mat |
1,612 |
1,325 |
$84K |
| K0001 |
Standard wheelchair |
1,414 |
1,239 |
$78K |
| E1028 |
W/c manual swingaway |
1,128 |
668 |
$53K |
| E0143 |
Walker folding wheeled w/o s |
1,010 |
870 |
$50K |
| K0823 |
Pwc gp 2 std cap chair |
400 |
353 |
$47K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,112 |
876 |
$28K |
| E0630 |
Patient lift hydraulic |
318 |
251 |
$18K |
| E0184 |
Dry pressure mattress |
458 |
388 |
$14K |
| E0156 |
Walker seat attachment |
1,049 |
922 |
$13K |
| A4670 |
Automatic bp monitor, dial |
199 |
186 |
$9K |
| E0303 |
Hosp bed hvy dty xtra wide |
26 |
24 |
$6K |
| E0955 |
Cushioned headrest |
144 |
108 |
$6K |
| E0570 |
Nebulizer with compression |
90 |
87 |
$4K |
| K0195 |
Elevating whlchair leg rests |
379 |
328 |
$3K |
| E0973 |
W/ch access det adj armrest |
19 |
15 |
$2K |
| E0240 |
Bath/shower chair |
16 |
16 |
$2K |
| E0247 |
Trans bench w/wo comm open |
13 |
13 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
43 |
26 |
$950.82 |
| K0040 |
Adjustable angle footplate |
16 |
12 |
$733.71 |