| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0003 |
Lightweight wheelchair |
1,725 |
1,721 |
$53K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
276 |
276 |
$5K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
325 |
321 |
$3K |
| B9002 |
Enteral nutrition infusion pump, any type |
127 |
126 |
$609.81 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
36 |
36 |
$330.14 |
| E0776 |
Iv pole |
321 |
319 |
$244.82 |