| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Pwc gp 2 std cap chair |
1,431 |
925 |
$58K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,147 |
2,128 |
$35K |
| K0001 |
Standard wheelchair |
5,628 |
3,841 |
$27K |
| E2611 |
Gen use back cush wdth <22in |
397 |
262 |
$20K |
| E0630 |
Patient lift hydraulic |
1,583 |
1,008 |
$12K |
| E0255 |
Hospital bed var ht w/ mattr |
1,143 |
704 |
$12K |
| E0973 |
W/ch access det adj armrest |
1,339 |
530 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
546 |
426 |
$7K |
| K0002 |
Stnd hemi (low seat) whlchr |
867 |
508 |
$6K |
| E0261 |
Hosp bed semi-electr w/o mat |
2,137 |
1,365 |
$5K |
| E1028 |
W/c manual swingaway |
459 |
171 |
$4K |
| K0003 |
Lightweight wheelchair |
345 |
225 |
$3K |
| E0256 |
Hospital bed var ht w/o matt |
1,378 |
851 |
$3K |
| K0195 |
Elevating whlchair leg rests |
1,480 |
1,067 |
$2K |
| E0971 |
Wheelchair anti-tipping devi |
867 |
337 |
$2K |
| E0955 |
Cushioned headrest |
223 |
144 |
$1K |
| E2601 |
Gen w/c cushion wdth < 22 in |
443 |
306 |
$1K |
| K0739 |
Repair/svc dme non-oxygen eq |
339 |
171 |
$1K |
| E0951 |
Loop heel |
783 |
308 |
$886.32 |
| E0961 |
Wheelchair brake extension |
653 |
254 |
$855.51 |
| E0978 |
W/c acc,saf belt pelv strap |
476 |
316 |
$527.37 |
| E0156 |
Walker seat attachment |
243 |
199 |
$396.55 |
| E0271 |
Mattress innerspring |
19 |
12 |
$374.37 |
| E0163 |
Commode chair with fixed arm |
15 |
12 |
$346.39 |
| E0184 |
Dry pressure mattress |
26 |
13 |
$342.03 |
| E0277 |
Powered pres-redu air mattrs |
17 |
12 |
$264.65 |
| K0006 |
Heavy duty wheelchair |
15 |
12 |
$158.09 |
| E0181 |
Press pad alternating w/ pum |
99 |
54 |
$113.75 |
| E0910 |
Trapeze bar attached to bed |
18 |
12 |
$37.82 |