| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,369 |
3,248 |
$283K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
927 |
901 |
$101K |
| K0001 |
Standard wheelchair |
3,206 |
3,037 |
$96K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
709 |
694 |
$72K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
557 |
509 |
$56K |
| T4541 |
Incontinence product, disposable underpad, large, each |
3,190 |
3,010 |
$52K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
942 |
883 |
$43K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
409 |
401 |
$42K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
639 |
619 |
$37K |
| A4927 |
Gloves, non-sterile, per 100 |
3,034 |
2,848 |
$36K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
344 |
321 |
$32K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
217 |
92 |
$28K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
161 |
155 |
$17K |
| E0245 |
Tub stool or bench |
195 |
180 |
$17K |
| K0003 |
Lightweight wheelchair |
358 |
343 |
$16K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,553 |
1,358 |
$14K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
168 |
151 |
$9K |
| A9270 |
Non-covered item or service |
764 |
688 |
$9K |
| E1399 |
Durable medical equipment, miscellaneous |
21 |
13 |
$9K |
| K0007 |
Extra heavy duty wheelchair |
51 |
48 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
669 |
597 |
$7K |
| K0006 |
Heavy duty wheelchair |
43 |
37 |
$4K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
121 |
119 |
$1K |
| K0002 |
Standard hemi (low seat) wheelchair |
28 |
24 |
$1K |