| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0005 |
Ultralightweight wheelchair |
290 |
279 |
$82K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
290 |
279 |
$10K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
289 |
278 |
$8K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
347 |
346 |
$6K |
| E2602 |
General use wheelchair seat cushion, width 22 inches or greater, any depth |
290 |
279 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
290 |
279 |
$3K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
75 |
74 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
290 |
279 |
$2K |
| K0001 |
Standard wheelchair |
152 |
152 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
18 |
18 |
$313.73 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
12 |
12 |
$136.45 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
12 |
12 |
$90.37 |
| E0156 |
Seat attachment, walker |
14 |
14 |
$67.43 |