| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1150 |
Wheelchair standard w/ leg r |
1,047 |
598 |
$17K |
| E1390 |
Oxygen concentrator |
464 |
301 |
$14K |
| K0001 |
Standard wheelchair |
1,169 |
767 |
$6K |
| E0260 |
Hosp bed semi-electr w/ matt |
348 |
233 |
$5K |
| E0600 |
Suction pump portab hom modl |
97 |
54 |
$4K |
| E0165 |
Commode chair with detacharm |
254 |
171 |
$3K |
| E0630 |
Patient lift hydraulic |
149 |
96 |
$3K |
| K0195 |
Elevating whlchair leg rests |
1,107 |
622 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
79 |
53 |
$2K |
| E0431 |
Portable gaseous 02 |
236 |
143 |
$1K |
| E0261 |
Hosp bed semi-electr w/o mat |
169 |
69 |
$1K |
| E0570 |
Nebulizer with compression |
13 |
12 |
$527.20 |
| E0443 |
Portable 02 contents, gas |
15 |
12 |
$321.91 |
| A7000 |
Disposable canister for pump |
39 |
27 |
$301.75 |