| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
2,114 |
1,923 |
$28K |
| K0001 |
Standard wheelchair |
3,364 |
3,048 |
$16K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
1,065 |
960 |
$7K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
4,044 |
2,210 |
$5K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
68 |
58 |
$3K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
244 |
227 |
$3K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
136 |
62 |
$785.69 |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
4,007 |
2,180 |
$631.57 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
96 |
83 |
$110.30 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
17 |
14 |
$70.81 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
16 |
12 |
$29.24 |