| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0143 |
Walker folding wheeled w/o s |
3,324 |
3,273 |
$106K |
| K0001 |
Standard wheelchair |
8,505 |
8,423 |
$101K |
| E2611 |
Gen use back cush wdth <22in |
386 |
378 |
$32K |
| A4670 |
Automatic bp monitor, dial |
468 |
462 |
$24K |
| E0245 |
Tub stool or bench |
559 |
555 |
$22K |
| E0163 |
Commode chair with fixed arm |
809 |
785 |
$21K |
| E0971 |
Wheelchair anti-tipping devi |
568 |
558 |
$14K |
| E0961 |
Wheelchair brake extension |
532 |
522 |
$9K |
| T4527 |
Adult size pull-on lg |
107 |
106 |
$8K |
| E2601 |
Gen w/c cushion wdth < 22 in |
402 |
391 |
$8K |
| K0195 |
Elevating whlchair leg rests |
2,964 |
2,933 |
$7K |
| E0260 |
Hosp bed semi-electr w/ matt |
195 |
192 |
$5K |
| K0004 |
High strength ltwt whlchr |
69 |
69 |
$5K |
| T4541 |
Large disposable underpad |
156 |
154 |
$5K |
| E0935 |
Cont pas motion exercise dev |
123 |
12 |
$3K |
| E0114 |
Crutch underarm pair no wood |
92 |
91 |
$2K |
| E0156 |
Walker seat attachment |
254 |
251 |
$2K |
| E0100 |
Cane adjust/fixed with tip |
151 |
149 |
$2K |
| T4528 |
Adult size pull-on xl |
12 |
12 |
$1K |
| K0003 |
Lightweight wheelchair |
29 |
29 |
$1K |
| E0990 |
Wheelchair elevating leg res |
14 |
13 |
$1K |
| K0007 |
Extra heavy duty wheelchair |
36 |
36 |
$1K |
| E0570 |
Nebulizer with compression |
14 |
13 |
$724.36 |