| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0261 |
Hosp bed semi-electr w/o mat |
8,490 |
6,158 |
$159K |
| K0823 |
Pwc gp 2 std cap chair |
1,662 |
1,345 |
$158K |
| K0001 |
Standard wheelchair |
10,953 |
8,709 |
$142K |
| E0240 |
Bath/shower chair |
596 |
488 |
$129K |
| E0260 |
Hosp bed semi-electr w/ matt |
4,221 |
3,248 |
$69K |
| K0195 |
Elevating whlchair leg rests |
7,126 |
5,498 |
$63K |
| E0630 |
Patient lift hydraulic |
4,101 |
2,927 |
$63K |
| E0266 |
Hosp bed total elec w/o matt |
115 |
55 |
$55K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
2,276 |
1,801 |
$50K |
| K0007 |
Extra heavy duty wheelchair |
599 |
448 |
$38K |
| K0003 |
Lightweight wheelchair |
2,491 |
1,935 |
$38K |
| E0143 |
Walker folding wheeled w/o s |
2,212 |
1,874 |
$33K |
| K0006 |
Heavy duty wheelchair |
672 |
534 |
$29K |
| E0277 |
Powered pres-redu air mattrs |
208 |
144 |
$26K |
| K0739 |
Repair/svc dme non-oxygen eq |
606 |
452 |
$22K |
| E0184 |
Dry pressure mattress |
537 |
390 |
$17K |
| E0570 |
Nebulizer with compression |
1,499 |
1,082 |
$16K |
| E0163 |
Commode chair with fixed arm |
801 |
655 |
$13K |
| E2365 |
U1 sealed leadacid battery |
259 |
178 |
$11K |
| E0156 |
Walker seat attachment |
1,465 |
1,276 |
$10K |
| E2601 |
Gen w/c cushion wdth < 22 in |
886 |
710 |
$10K |
| E0910 |
Trapeze bar attached to bed |
864 |
623 |
$8K |
| E0149 |
Heavy duty wheeled walker |
898 |
764 |
$8K |
| E2611 |
Gen use back cush wdth <22in |
194 |
138 |
$7K |
| T4541 |
Large disposable underpad |
243 |
201 |
$4K |
| E0247 |
Trans bench w/wo comm open |
30 |
24 |
$3K |
| E1028 |
W/c manual swingaway |
39 |
25 |
$3K |
| E2386 |
Foam filled drive wheel tire |
88 |
40 |
$3K |
| K0462 |
Temporary replacement eqpmnt |
84 |
56 |
$2K |
| E1226 |
Manual fully reclining back |
32 |
25 |
$2K |
| E2395 |
Caster wheel excludes tire |
80 |
53 |
$2K |
| E2394 |
Drive wheel excludes tire |
86 |
38 |
$1K |
| E2361 |
22nf sealed leadacid battery |
12 |
12 |
$1K |
| E1038 |
Transport chair pt wt<=300lb |
654 |
464 |
$1K |
| E0295 |
Hosp bed semi-elect w/o matt |
263 |
170 |
$1K |
| T4528 |
Adult size pull-on xl |
14 |
12 |
$1K |
| E0165 |
Commode chair with detacharm |
448 |
368 |
$1K |
| E2387 |
Foam filled caster tire |
62 |
40 |
$1K |
| E0973 |
W/ch access det adj armrest |
31 |
24 |
$1K |
| T4527 |
Adult size pull-on lg |
13 |
12 |
$561.16 |
| E0305 |
Rails bed side half length |
86 |
60 |
$100.82 |