| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
381 |
355 |
$23K |
| K0001 |
Standard wheelchair |
2,014 |
1,850 |
$14K |
| E0143 |
Walker folding wheeled w/o s |
539 |
474 |
$12K |
| E0247 |
Trans bench w/wo comm open |
142 |
118 |
$10K |
| E0245 |
Tub stool or bench |
133 |
93 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
404 |
385 |
$3K |
| E2601 |
Gen w/c cushion wdth < 22 in |
120 |
97 |
$3K |
| E2611 |
Gen use back cush wdth <22in |
33 |
28 |
$2K |
| K0195 |
Elevating whlchair leg rests |
851 |
776 |
$2K |
| K0003 |
Lightweight wheelchair |
202 |
196 |
$2K |
| K0006 |
Heavy duty wheelchair |
130 |
128 |
$2K |
| E0431 |
Portable gaseous 02 |
122 |
103 |
$2K |
| E0163 |
Commode chair with fixed arm |
38 |
33 |
$830.80 |
| E0156 |
Walker seat attachment |
60 |
46 |
$483.20 |
| E0971 |
Wheelchair anti-tipping devi |
58 |
32 |
$410.22 |
| E0181 |
Press pad alternating w/ pum |
36 |
36 |
$139.22 |
| E0630 |
Patient lift hydraulic |
13 |
13 |
$130.70 |
| E0165 |
Commode chair with detacharm |
28 |
27 |
$68.61 |