| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A0380 |
Bls mileage (per mile) |
3,034 |
766 |
$160K |
| A0130 |
Non-emergency transportation: wheelchair van |
3,272 |
765 |
$123K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
702 |
700 |
$7K |
| K0003 |
Lightweight wheelchair |
835 |
831 |
$4K |
| E0305 |
Bed side rails, half length |
714 |
713 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
140 |
138 |
$939.84 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
120 |
118 |
$675.66 |
| E0245 |
Tub stool or bench |
13 |
13 |
$123.54 |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
12 |
12 |
$81.42 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
24 |
24 |
$58.39 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
24 |
12 |
$16.86 |