| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0195 |
Elevating whlchair leg rests |
3,494 |
3,096 |
$163K |
| E1390 |
Oxygen concentrator |
1,418 |
1,090 |
$70K |
| K0001 |
Standard wheelchair |
4,991 |
4,217 |
$53K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,754 |
1,510 |
$44K |
| E0971 |
Wheelchair anti-tipping devi |
2,522 |
2,321 |
$33K |
| E0973 |
W/ch access det adj armrest |
2,466 |
2,251 |
$29K |
| E0978 |
W/c acc,saf belt pelv strap |
2,333 |
2,174 |
$11K |
| E0600 |
Suction pump portab hom modl |
1,218 |
912 |
$9K |
| E0431 |
Portable gaseous 02 |
1,475 |
1,019 |
$7K |
| K0007 |
Extra heavy duty wheelchair |
274 |
245 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
154 |
122 |
$5K |
| E0630 |
Patient lift hydraulic |
282 |
246 |
$3K |
| E0443 |
Portable 02 contents, gas |
170 |
39 |
$1K |
| E0277 |
Powered pres-redu air mattrs |
113 |
77 |
$1K |
| K0003 |
Lightweight wheelchair |
44 |
41 |
$832.89 |
| E0163 |
Commode chair with fixed arm |
34 |
27 |
$631.78 |
| E0570 |
Nebulizer with compression |
13 |
12 |
$179.53 |
| E1353 |
Oxygen supplies regulator |
29 |
25 |
$0.00 |