| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
22 |
16 |
$57K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
1,654 |
1,520 |
$25K |
| K0001 |
Standard wheelchair |
1,716 |
1,567 |
$17K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
770 |
671 |
$6K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,391 |
1,248 |
$4K |
| T4541 |
Incontinence product, disposable underpad, large, each |
73 |
71 |
$3K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
13 |
12 |
$2K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
83 |
83 |
$1K |
| E0570 |
Nebulizer, with compressor |
14 |
12 |
$718.09 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
86 |
85 |
$256.30 |