| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0003 |
Lightweight wheelchair |
182 |
170 |
$5K |
| E0745 |
Neuromuscular stimulator, electronic shock unit |
14 |
13 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
283 |
253 |
$3K |
| E0731 |
Form fitting conductive garment for delivery of tens or nmes (with conductive fibers separated from the patient's skin by layers of fabric) |
14 |
13 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
35 |
27 |
$637.03 |
| L3040 |
Foot, arch support, removable, premolded, longitudinal, each |
30 |
12 |
$471.24 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
14 |
12 |
$292.26 |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
14 |
13 |
$172.25 |
| A4557 |
Lead wires, (e.g., apnea monitor), per pair |
14 |
13 |
$126.32 |