| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hosp bed semi-electr w/ matt |
3,857 |
2,240 |
$39K |
| K0001 |
Standard wheelchair |
6,601 |
4,015 |
$30K |
| E2611 |
Gen use back cush wdth <22in |
787 |
467 |
$24K |
| E0265 |
Hosp bed total electr w/ mat |
1,004 |
581 |
$20K |
| E0163 |
Commode chair with fixed arm |
1,505 |
917 |
$17K |
| E0973 |
W/ch access det adj armrest |
1,518 |
478 |
$11K |
| E1390 |
Oxygen concentrator |
766 |
454 |
$10K |
| E0971 |
Wheelchair anti-tipping devi |
1,519 |
478 |
$6K |
| E2601 |
Gen w/c cushion wdth < 22 in |
766 |
454 |
$3K |
| K0195 |
Elevating whlchair leg rests |
2,829 |
1,745 |
$3K |
| E0141 |
Rigid wheeled walker adj/fix |
285 |
183 |
$2K |
| E0431 |
Portable gaseous 02 |
763 |
449 |
$2K |
| E0185 |
Gel pressure mattress pad |
84 |
44 |
$1K |
| E0630 |
Patient lift hydraulic |
21 |
13 |
$85.36 |
| E1038 |
Transport chair pt wt<=300lb |
150 |
110 |
$77.28 |