| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
259 |
254 |
$26K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
66 |
39 |
$4K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
128 |
127 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
259 |
135 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
56 |
53 |
$780.90 |
| K0001 |
Standard wheelchair |
211 |
206 |
$628.77 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
12 |
12 |
$103.65 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
64 |
62 |
$53.64 |