| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0001 |
Standard wheelchair |
7,278 |
4,991 |
$52K |
| E0260 |
Hosp bed semi-electr w/ matt |
7,751 |
5,540 |
$41K |
| E1390 |
Oxygen concentrator |
1,471 |
1,218 |
$36K |
| K0004 |
High strength ltwt whlchr |
2,671 |
1,676 |
$21K |
| K0195 |
Elevating whlchair leg rests |
11,040 |
7,323 |
$12K |
| E0143 |
Walker folding wheeled w/o s |
915 |
627 |
$11K |
| E0630 |
Patient lift hydraulic |
2,086 |
1,419 |
$9K |
| E0431 |
Portable gaseous 02 |
1,296 |
1,056 |
$4K |
| K0003 |
Lightweight wheelchair |
569 |
356 |
$4K |
| E0163 |
Commode chair with fixed arm |
601 |
424 |
$4K |
| E0973 |
W/ch access det adj armrest |
363 |
127 |
$3K |
| E2611 |
Gen use back cush wdth <22in |
241 |
165 |
$2K |
| E0570 |
Nebulizer with compression |
2,872 |
2,240 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
317 |
212 |
$1K |
| E0971 |
Wheelchair anti-tipping devi |
324 |
216 |
$1K |
| K0002 |
Stnd hemi (low seat) whlchr |
96 |
67 |
$959.51 |
| E0978 |
W/c acc,saf belt pelv strap |
286 |
192 |
$376.04 |
| E0277 |
Powered pres-redu air mattrs |
102 |
87 |
$194.90 |
| E1038 |
Transport chair pt wt<=300lb |
52 |
38 |
$37.50 |
| A7005 |
Nondisposable nebulizer set |
57 |
52 |
$23.48 |
| E0165 |
Commode chair with detacharm |
36 |
25 |
$19.03 |
| E0185 |
Gel pressure mattress pad |
187 |
158 |
$0.00 |