| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L0650 |
Lso sc r ant/pos pnl pre ots |
2,569 |
2,554 |
$178K |
| A4595 |
Tens suppl 2 lead per month |
20,375 |
20,038 |
$56K |
| L1833 |
Ko adj jnt pos r sup pre ots |
1,000 |
968 |
$47K |
| A4670 |
Automatic bp monitor, dial |
274 |
274 |
$34K |
| E0730 |
Tens four lead |
4,940 |
4,832 |
$18K |
| K0001 |
Standard wheelchair |
1,066 |
1,061 |
$18K |
| L3809 |
Whfo w/o joints pre ots |
530 |
501 |
$15K |
| K0003 |
Lightweight wheelchair |
850 |
843 |
$15K |
| E0973 |
W/ch access det adj armrest |
1,024 |
837 |
$13K |
| E2611 |
Gen use back cush wdth <22in |
439 |
435 |
$10K |
| L3916 |
Who nontorsion jnts pre ots |
80 |
76 |
$9K |
| L2810 |
Knee control condylar pad |
1,084 |
1,053 |
$8K |
| E0971 |
Wheelchair anti-tipping devi |
731 |
607 |
$5K |
| L2397 |
Suspension sleeve lower ext |
1,078 |
1,048 |
$5K |
| L2795 |
Knee control full kneecap |
1,051 |
1,021 |
$5K |
| E0570 |
Nebulizer with compression |
251 |
246 |
$4K |
| E0720 |
Tens two lead |
26 |
26 |
$4K |
| E0990 |
Wheelchair elevating leg res |
187 |
182 |
$4K |
| E0961 |
Wheelchair brake extension |
725 |
609 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
409 |
401 |
$3K |
| E0951 |
Loop heel |
790 |
656 |
$2K |
| E0978 |
W/c acc,saf belt pelv strap |
537 |
524 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
366 |
365 |
$2K |
| K0195 |
Elevating whlchair leg rests |
880 |
880 |
$1K |
| E1236 |
Folding ped wc adjustable |
25 |
25 |
$1K |
| A7005 |
Nondisposable nebulizer set |
202 |
196 |
$886.00 |
| E0245 |
Tub stool or bench |
109 |
109 |
$720.82 |
| E0156 |
Walker seat attachment |
315 |
308 |
$683.56 |
| E0247 |
Trans bench w/wo comm open |
29 |
29 |
$415.93 |
| E0163 |
Commode chair with fixed arm |
39 |
39 |
$240.98 |
| A4557 |
Lead wires, pair |
12 |
12 |
$180.00 |
| A7015 |
Aerosol mask used w nebulize |
290 |
277 |
$49.50 |