| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0004 |
High strength, lightweight wheelchair |
430 |
373 |
$20K |
| E0245 |
Tub stool or bench |
197 |
188 |
$6K |
| E1399 |
Durable medical equipment, miscellaneous |
196 |
118 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
122 |
113 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
380 |
353 |
$3K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
74 |
64 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
33 |
33 |
$2K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
30 |
26 |
$951.40 |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
27 |
27 |
$811.52 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
17 |
17 |
$802.00 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
14 |
12 |
$370.40 |
| E0156 |
Seat attachment, walker |
24 |
24 |
$174.70 |