| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Pwc gp 2 std cap chair |
273 |
164 |
$22K |
| K0003 |
Lightweight wheelchair |
598 |
470 |
$14K |
| E0260 |
Hosp bed semi-electr w/ matt |
873 |
551 |
$12K |
| E2611 |
Gen use back cush wdth <22in |
384 |
241 |
$9K |
| E0973 |
W/ch access det adj armrest |
548 |
213 |
$8K |
| E0971 |
Wheelchair anti-tipping devi |
548 |
209 |
$5K |
| K0002 |
Stnd hemi (low seat) whlchr |
385 |
218 |
$5K |
| E0143 |
Walker folding wheeled w/o s |
158 |
116 |
$4K |
| E0961 |
Wheelchair brake extension |
600 |
218 |
$3K |
| E0990 |
Wheelchair elevating leg res |
18 |
13 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
238 |
151 |
$2K |
| E0630 |
Patient lift hydraulic |
103 |
64 |
$2K |
| E0978 |
W/c acc,saf belt pelv strap |
281 |
176 |
$2K |
| E1240 |
Whchr litwt det arm leg rest |
407 |
301 |
$2K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
14 |
13 |
$2K |
| K0195 |
Elevating whlchair leg rests |
1,486 |
857 |
$1K |
| E0185 |
Gel pressure mattress pad |
36 |
25 |
$1K |
| E0165 |
Commode chair with detacharm |
42 |
25 |
$935.07 |
| E0294 |
Hosp bed semi-elect w/ mattr |
53 |
37 |
$456.84 |