| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,301 |
2,214 |
$43K |
| K0001 |
Standard wheelchair |
3,749 |
2,399 |
$19K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,290 |
877 |
$2K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
87 |
49 |
$1K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
41 |
24 |
$687.24 |
| A4259 |
Lancets, per box of 100 |
530 |
369 |
$671.14 |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
37 |
31 |
$377.52 |
| E0570 |
Nebulizer, with compressor |
311 |
194 |
$261.48 |
| E0141 |
Walker, rigid, wheeled, adjustable or fixed height |
27 |
22 |
$181.73 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
350 |
225 |
$152.97 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
38 |
31 |
$93.45 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
531 |
370 |
$74.36 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
19 |
16 |
$63.84 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
17 |
15 |
$43.44 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
17 |
15 |
$23.60 |
| E0156 |
Seat attachment, walker |
16 |
16 |
$9.42 |
| A4256 |
Normal, low and high calibrator solution / chips |
166 |
106 |
$1.36 |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
13 |
13 |
$0.00 |