| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Pwc gp 2 std cap chair |
1,393 |
1,076 |
$117K |
| E1390 |
Oxygen concentrator |
2,914 |
2,245 |
$107K |
| E0601 |
Cont airway pressure device |
1,701 |
1,541 |
$71K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,796 |
3,365 |
$59K |
| K0001 |
Standard wheelchair |
3,162 |
2,296 |
$25K |
| K0003 |
Lightweight wheelchair |
2,122 |
1,563 |
$22K |
| K0800 |
Pov group 1 std up to 300lbs |
56 |
45 |
$12K |
| E0630 |
Patient lift hydraulic |
751 |
528 |
$9K |
| E0431 |
Portable gaseous 02 |
397 |
373 |
$7K |
| E0570 |
Nebulizer with compression |
740 |
538 |
$7K |
| E2611 |
Gen use back cush wdth <22in |
74 |
49 |
$4K |
| E0562 |
Humidifier heated used w pap |
862 |
832 |
$4K |
| E0955 |
Cushioned headrest |
84 |
67 |
$2K |
| K0195 |
Elevating whlchair leg rests |
703 |
494 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
194 |
69 |
$764.77 |
| K0738 |
Portable gas oxygen system |
1,043 |
802 |
$456.51 |
| E0961 |
Wheelchair brake extension |
155 |
53 |
$421.29 |
| E2601 |
Gen w/c cushion wdth < 22 in |
56 |
37 |
$338.21 |
| E0978 |
W/c acc,saf belt pelv strap |
66 |
42 |
$200.64 |
| E0951 |
Loop heel |
73 |
29 |
$191.44 |
| E2361 |
22nf sealed leadacid battery |
17 |
13 |
$185.08 |
| E1028 |
W/c manual swingaway |
23 |
12 |
$117.98 |