| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2321 |
Power wheelchair accessory, hand control interface, remote joystick, nonproportional, including all related electronics, mechanical stop switch, and fixed mounting hardware |
49 |
49 |
$2K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
49 |
49 |
$569.76 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
14 |
13 |
$78.00 |
| A4259 |
Lancets, per box of 100 |
14 |
13 |
$7.10 |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
12 |
12 |
$0.00 |