| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
373 |
371 |
$24K |
| K0003 |
Lightweight wheelchair |
1,439 |
1,396 |
$20K |
| K0002 |
Standard hemi (low seat) wheelchair |
840 |
838 |
$12K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
161 |
161 |
$10K |
| K0001 |
Standard wheelchair |
308 |
307 |
$3K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
13 |
13 |
$536.12 |
| E0141 |
Walker, rigid, wheeled, adjustable or fixed height |
12 |
12 |
$266.45 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
13 |
13 |
$185.47 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
13 |
13 |
$119.88 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
26 |
26 |
$83.46 |