| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hosp bed semi-electr w/ matt |
9,097 |
8,993 |
$174K |
| K0001 |
Standard wheelchair |
15,203 |
15,033 |
$163K |
| K0002 |
Stnd hemi (low seat) whlchr |
8,144 |
8,035 |
$134K |
| K0003 |
Lightweight wheelchair |
4,208 |
4,172 |
$65K |
| E0143 |
Walker folding wheeled w/o s |
3,651 |
3,606 |
$64K |
| E0163 |
Commode chair with fixed arm |
2,910 |
2,856 |
$59K |
| E1390 |
Oxygen concentrator |
1,651 |
1,633 |
$51K |
| E0630 |
Patient lift hydraulic |
2,534 |
2,520 |
$43K |
| E2601 |
Gen w/c cushion wdth < 22 in |
2,399 |
2,376 |
$22K |
| K0195 |
Elevating whlchair leg rests |
4,639 |
4,582 |
$16K |
| K0823 |
Pwc gp 2 std cap chair |
158 |
157 |
$10K |
| B4035 |
Enteral feed supp pump per d |
190 |
175 |
$10K |
| E0250 |
Hosp bed fixed ht w/ mattres |
463 |
459 |
$9K |
| E0431 |
Portable gaseous 02 |
1,680 |
1,664 |
$9K |
| K0006 |
Heavy duty wheelchair |
208 |
206 |
$5K |
| E2611 |
Gen use back cush wdth <22in |
119 |
119 |
$4K |
| E0295 |
Hosp bed semi-elect w/o matt |
243 |
243 |
$4K |
| E1038 |
Transport chair pt wt<=300lb |
650 |
639 |
$3K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
183 |
174 |
$2K |
| E0600 |
Suction pump portab hom modl |
129 |
129 |
$2K |
| E0156 |
Walker seat attachment |
484 |
479 |
$2K |
| E0776 |
Iv pole |
156 |
151 |
$1K |
| E0961 |
Wheelchair brake extension |
198 |
197 |
$1K |
| E0910 |
Trapeze bar attached to bed |
574 |
569 |
$1K |
| E0570 |
Nebulizer with compression |
558 |
555 |
$1K |
| E0978 |
W/c acc,saf belt pelv strap |
200 |
198 |
$943.54 |
| B4154 |
Ef spec metabolic noninherit |
14 |
13 |
$742.61 |
| K0007 |
Extra heavy duty wheelchair |
12 |
12 |
$500.01 |
| E0271 |
Mattress innerspring |
12 |
12 |
$359.39 |
| E0310 |
Rails bed side full length |
12 |
12 |
$349.23 |
| E1226 |
Manual fully reclining back |
49 |
49 |
$312.70 |
| E0966 |
Wheelchair head rest extensi |
74 |
74 |
$134.49 |
| E0159 |
Brake for wheeled walker |
46 |
46 |
$124.03 |