| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A9999 |
Miscellaneous dme supply or accessory, not otherwise specified |
659 |
556 |
$51K |
| E1399 |
Durable medical equipment, miscellaneous |
113 |
83 |
$27K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
171 |
121 |
$23K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
191 |
170 |
$9K |
| K0001 |
Standard wheelchair |
712 |
652 |
$5K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
159 |
134 |
$4K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
277 |
170 |
$2K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
219 |
201 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
82 |
75 |
$1K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
41 |
13 |
$1K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
19 |
13 |
$835.85 |
| K0002 |
Standard hemi (low seat) wheelchair |
121 |
119 |
$815.63 |
| E0156 |
Seat attachment, walker |
15 |
14 |
$108.68 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12 |
12 |
$9.54 |