| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0261 |
Hosp bed semi-electr w/o mat |
1,649 |
1,553 |
$19K |
| K0001 |
Standard wheelchair |
2,040 |
1,905 |
$9K |
| B4152 |
Ef calorie dense>/=1.5kcal |
294 |
237 |
$9K |
| B4150 |
Ef complet w/intact nutrient |
231 |
206 |
$8K |
| B4034 |
Enter feed supkit syr by day |
499 |
451 |
$8K |
| E0630 |
Patient lift hydraulic |
753 |
712 |
$8K |
| B4035 |
Enteral feed supp pump per d |
195 |
169 |
$5K |
| K0003 |
Lightweight wheelchair |
738 |
667 |
$5K |
| E0260 |
Hosp bed semi-electr w/ matt |
379 |
345 |
$4K |
| E0277 |
Powered pres-redu air mattrs |
127 |
109 |
$3K |
| K0195 |
Elevating whlchair leg rests |
924 |
849 |
$2K |
| E2611 |
Gen use back cush wdth <22in |
69 |
54 |
$2K |
| B9002 |
Enter nutr inf pump any type |
157 |
135 |
$1K |
| B4154 |
Ef spec metabolic noninherit |
12 |
12 |
$1K |
| E1390 |
Oxygen concentrator |
68 |
65 |
$1K |
| E0163 |
Commode chair with fixed arm |
89 |
74 |
$817.82 |
| E0776 |
Iv pole |
602 |
594 |
$627.64 |
| E0971 |
Wheelchair anti-tipping devi |
85 |
67 |
$580.19 |
| E2601 |
Gen w/c cushion wdth < 22 in |
78 |
63 |
$531.53 |
| E0961 |
Wheelchair brake extension |
70 |
53 |
$347.09 |
| E0184 |
Dry pressure mattress |
16 |
12 |
$302.62 |
| E0143 |
Walker folding wheeled w/o s |
22 |
20 |
$182.42 |
| E1038 |
Transport chair pt wt<=300lb |
42 |
41 |
$130.69 |
| E0951 |
Loop heel |
63 |
50 |
$92.92 |
| E0978 |
W/c acc,saf belt pelv strap |
83 |
66 |
$11.39 |
| E0600 |
Suction pump portab hom modl |
13 |
12 |
$6.57 |