| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0265 |
Hosp bed total electr w/ mat |
1,520 |
1,417 |
$53K |
| E1399 |
Durable medical equipment mi |
396 |
276 |
$28K |
| E0147 |
Walker variable wheel resist |
140 |
133 |
$14K |
| S5165 |
Home modifications per serv |
22 |
22 |
$9K |
| E0260 |
Hosp bed semi-electr w/ matt |
513 |
484 |
$7K |
| E0277 |
Powered pres-redu air mattrs |
167 |
135 |
$7K |
| E0303 |
Hosp bed hvy dty xtra wide |
90 |
90 |
$4K |
| K0004 |
High strength ltwt whlchr |
127 |
123 |
$3K |
| E0240 |
Bath/shower chair |
46 |
45 |
$2K |
| E1038 |
Transport chair pt wt<=300lb |
353 |
349 |
$2K |
| K0003 |
Lightweight wheelchair |
150 |
140 |
$2K |
| K0739 |
Repair/svc dme non-oxygen eq |
33 |
33 |
$730.40 |
| E0156 |
Walker seat attachment |
145 |
141 |
$720.00 |