| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hosp bed semi-electr w/ matt |
19,562 |
19,110 |
$313K |
| K0003 |
Lightweight wheelchair |
18,616 |
18,052 |
$257K |
| E0277 |
Powered pres-redu air mattrs |
2,765 |
2,693 |
$174K |
| A5500 |
Diab shoe for density insert |
5,432 |
3,585 |
$135K |
| A5512 |
Multi den insert direct form |
5,450 |
3,583 |
$133K |
| K0823 |
Pwc gp 2 std cap chair |
363 |
354 |
$129K |
| E0185 |
Gel pressure mattress pad |
2,236 |
2,134 |
$82K |
| E0630 |
Patient lift hydraulic |
4,697 |
4,574 |
$80K |
| E0973 |
W/ch access det adj armrest |
1,587 |
1,448 |
$70K |
| E2611 |
Gen use back cush wdth <22in |
1,125 |
1,040 |
$62K |
| E0971 |
Wheelchair anti-tipping devi |
2,191 |
2,018 |
$43K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
3,162 |
3,035 |
$40K |
| E0961 |
Wheelchair brake extension |
2,340 |
2,151 |
$31K |
| E2601 |
Gen w/c cushion wdth < 22 in |
1,385 |
1,273 |
$21K |
| E0163 |
Commode chair with fixed arm |
903 |
847 |
$21K |
| E0143 |
Walker folding wheeled w/o s |
613 |
590 |
$17K |
| K0007 |
Extra heavy duty wheelchair |
494 |
443 |
$16K |
| E0261 |
Hosp bed semi-electr w/o mat |
861 |
811 |
$15K |
| E0951 |
Loop heel |
1,582 |
1,478 |
$12K |
| K0195 |
Elevating whlchair leg rests |
5,401 |
5,148 |
$10K |
| E0165 |
Commode chair with detacharm |
2,920 |
2,804 |
$9K |
| K0006 |
Heavy duty wheelchair |
499 |
483 |
$9K |
| E2202 |
Seat width 24-27 in |
421 |
373 |
$8K |
| E1226 |
Manual fully reclining back |
655 |
624 |
$6K |
| E0910 |
Trapeze bar attached to bed |
1,066 |
1,046 |
$3K |
| K0001 |
Standard wheelchair |
108 |
105 |
$2K |
| E0955 |
Cushioned headrest |
723 |
686 |
$2K |
| E0156 |
Walker seat attachment |
301 |
291 |
$2K |
| E2622 |
Adj skin pro w/c cus wd<22in |
12 |
12 |
$930.51 |