| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0004 |
High strength ltwt whlchr |
430 |
373 |
$20K |
| E0245 |
Tub stool or bench |
197 |
188 |
$6K |
| E1399 |
Durable medical equipment mi |
196 |
118 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
122 |
113 |
$4K |
| K0195 |
Elevating whlchair leg rests |
380 |
353 |
$3K |
| K0739 |
Repair/svc dme non-oxygen eq |
74 |
64 |
$2K |
| E0260 |
Hosp bed semi-electr w/ matt |
33 |
33 |
$2K |
| E0265 |
Hosp bed total electr w/ mat |
30 |
26 |
$951.40 |
| E2201 |
Man w/ch acc seat w>=20"<24" |
27 |
27 |
$811.52 |
| E0163 |
Commode chair with fixed arm |
17 |
17 |
$802.00 |
| E0261 |
Hosp bed semi-electr w/o mat |
14 |
12 |
$370.40 |
| E0156 |
Walker seat attachment |
24 |
24 |
$174.70 |