| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0001 |
Standard wheelchair |
5,624 |
3,903 |
$95K |
| E0143 |
Walker folding wheeled w/o s |
2,275 |
1,597 |
$94K |
| E1390 |
Oxygen concentrator |
1,498 |
973 |
$92K |
| K0195 |
Elevating whlchair leg rests |
6,357 |
4,438 |
$53K |
| E0163 |
Commode chair with fixed arm |
1,220 |
861 |
$48K |
| E0971 |
Wheelchair anti-tipping devi |
674 |
440 |
$26K |
| E1226 |
Manual fully reclining back |
855 |
704 |
$26K |
| E0570 |
Nebulizer with compression |
2,039 |
1,074 |
$20K |
| E0260 |
Hosp bed semi-electr w/ matt |
798 |
455 |
$19K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
997 |
668 |
$12K |
| E0431 |
Portable gaseous 02 |
514 |
363 |
$6K |
| E1238 |
Fld ped wc adjstabl w/o seat |
28 |
24 |
$3K |
| K0003 |
Lightweight wheelchair |
121 |
91 |
$3K |
| K0738 |
Portable gas oxygen system |
144 |
98 |
$3K |
| K0040 |
Adjustable angle footplate |
323 |
157 |
$2K |
| E0156 |
Walker seat attachment |
193 |
120 |
$1K |
| E0149 |
Heavy duty wheeled walker |
41 |
24 |
$1K |
| E0165 |
Commode chair with detacharm |
44 |
24 |
$855.35 |
| A7003 |
Nebulizer administration set |
113 |
75 |
$130.74 |
| A7015 |
Aerosol mask used w nebulize |
36 |
27 |
$27.71 |