| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4353 |
Intermittent urinary cath |
348 |
306 |
$300K |
| K0003 |
Lightweight wheelchair |
6,970 |
6,057 |
$190K |
| A4351 |
Straight tip urine catheter |
657 |
621 |
$104K |
| E0261 |
Hosp bed semi-electr w/o mat |
3,133 |
2,714 |
$93K |
| E2611 |
Gen use back cush wdth <22in |
612 |
482 |
$43K |
| E0630 |
Patient lift hydraulic |
856 |
738 |
$20K |
| K0001 |
Standard wheelchair |
915 |
800 |
$19K |
| K0195 |
Elevating whlchair leg rests |
2,686 |
2,323 |
$16K |
| E0973 |
W/ch access det adj armrest |
866 |
401 |
$14K |
| E0260 |
Hosp bed semi-electr w/ matt |
173 |
121 |
$13K |
| E2601 |
Gen w/c cushion wdth < 22 in |
750 |
587 |
$10K |
| E0971 |
Wheelchair anti-tipping devi |
1,017 |
473 |
$8K |
| K0006 |
Heavy duty wheelchair |
226 |
180 |
$5K |
| A4357 |
Bedside drainage bag |
388 |
362 |
$5K |
| E0163 |
Commode chair with fixed arm |
189 |
147 |
$3K |
| E0978 |
W/c acc,saf belt pelv strap |
399 |
306 |
$3K |
| E0184 |
Dry pressure mattress |
42 |
27 |
$3K |
| E0951 |
Loop heel |
719 |
345 |
$3K |
| A4358 |
Urinary leg or abdomen bag |
335 |
312 |
$2K |
| E0143 |
Walker folding wheeled w/o s |
38 |
37 |
$464.98 |