R1RC Worksheet TOC - Respiratory

33 Pages·2013·0.31 MB·English

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)
Competitive Bidding Program  Round 2

Single Payment Amounts

Support Surfaces (Group 2 Mattresses and Overlays)

Akron, OH 4
Albany-Schenectady-Troy, NY 4
Albuquerque, NM 4
Allentown-Bethlehem-Easton, PA-NJ 4
Asheville, NC 5
Atlanta-Sandy Springs-Marietta, GA 5
Augusta-Richmond County, GA-SC 5
Austin-Round Rock-San Marcos, TX 6
Bakersfield-Delano, CA 6
Baltimore-Towson, MD 6
Baton Rouge, LA 6
Beaumont-Port Arthur, TX 7
Birmingham-Hoover, AL 7
Boise City-Nampa, ID 7
Boston-Cambridge-Quincy, MA-NH 8
Bridgeport-Stamford-Norwalk, CT 8
Bronx-Manhattan, NY CBA 8
Buffalo-Niagara Falls, NY 9
Cape Coral-Fort Myers, FL 9
Central-Chicago Metro CBA 9
Charleston-North Charleston-Summerville, SC 9
Chattanooga, TN-GA 10
Colorado Springs, CO 10
Columbia, SC 10
Columbus, OH 11
Dayton, OH 11
Deltona-Daytona Beach-Ormond Beach, FL 11
Denver-Aurora-Broomfield, CO 11
Detroit-Warren-Livonia, MI 12
El Paso, TX 12
Flint, MI 12
Fresno, CA 13
Grand Rapids-Wyoming, MI 13
Greensboro-High Point, NC 13
Greenville-Mauldin-Easley, SC 14
Hartford-West Hartford-East Hartford, CT 14
Honolulu, HI 14
Houston-Sugar Land-Baytown, TX 14
Huntington-Ashland, WV-KY-OH 15
Indiana-Chicago Metro 15
Indianapolis-Carmel, IN 15
Jackson, MS 16
Jacksonville, FL 16
Knoxville, TN 16
Lakeland-Winter Haven, FL 16
Las Vegas-Paradise, NV 17
Little Rock-North Little Rock-Conway, AR 17
Los Angeles County CBA 17
Louisville/Jefferson County, KY-IN 18
McAllen-Edinburg-Mission, TX 18
Memphis, TN-MS-AR 18
Milwaukee-Waukesha-West Allis, WI 19
Minneapolis-St. Paul-Bloomington, MN-WI 19
Nashville-Davidson--Murfreesboro--Franklin, TN 19
Nassau-Brooklyn-Queens-Richmond County Metro CBA 19
New Haven-Milford, CT 20
New Orleans-Metairie-Kenner, LA 20
North East NY CBA Metro 20
North Port-Bradenton-Sarasota, FL 21
Northern NJ Metro CBA 21
Northern-Chicago Metro CBA 21
Ocala, FL 21
Oklahoma City, OK 22
Omaha-Council Bluffs, NE-IA 22
Orange County CBA 22
Oxnard-Thousand Oaks-Ventura, CA 23

DMEPOS Competitive Bidding P r o g r a m Round 2 SPA - Effective July 01, 2013 Page 2 of 33
Palm Bay-Melbourne-Titusville, FL 23
Philadelphia-Camden-Wilmington, PA-NJ-DE-MD 23
Phoenix-Mesa-Glendale, AZ 24
Portland-Vancouver-Hillsboro, OR-WA 24
Poughkeepsie-Newburgh-Middletown, NY 24
Providence-New Bedford-Fall River, RI-MA 24
Raleigh-Cary, NC 25
Richmond, VA 25
Rochester, NY 25
Sacramento--Arden-Arcade--Roseville, CA 26
Salt Lake City, UT 26
San Antonio-New Braunfels, TX 26
San Diego-Carlsbad-San Marcos, CA 26
San Francisco-Oakland-Fremont, CA 27
San Jose-Sunnyvale-Santa Clara, CA 27
Scranton--Wilkes-Barre, PA 27
Seattle-Tacoma-Bellevue, WA 28
South-West-Chicago-Metro CBA 28
Southern NY Metro CBA 28
Springfield, MA 29
St. Louis, MO-IL 29
Stockton, CA 29
Suffolk County CBA 29
Syracuse, NY 30
Tampa-St. Petersburg-Clearwater, FL 30
Toledo, OH 30
Tucson, AZ 31
Tulsa, OK 31
Virginia Beach-Norfolk-Newport News, VA-NC 31
Visalia-Porterville, CA 31
Washington-Arlington-Alexandria, DC-VA-MD-WV 32
Wichita, KS 32
Worcester, MA 32
Youngstown-Warren-Boardman, OH-PA 33

DMEPOS Competitive Bidding P r o g r a m Round 2 SPA - Effective July 01, 2013 Page 3 of 33
Support Surfaces (Group 2 Mattresses and Overlays)
HCPCS
CBA Name Code HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Akron, OH E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $677.50
Akron, OH E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $210.31
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Akron, OH E0371 MATTRESS LENGTH AND WIDTH RR $246.55
Akron, OH E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $225.00
Akron, OH E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $323.37
Albany-Schenectady-Troy, NY E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $724.65
Albany-Schenectady-Troy, NY E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $212.81
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Albany-Schenectady-Troy, NY E0371 MATTRESS LENGTH AND WIDTH RR $243.10
Albany-Schenectady-Troy, NY E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $225.00
Albany-Schenectady-Troy, NY E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $297.71
Albuquerque, NM E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $713.91
Albuquerque, NM E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $217.82
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Albuquerque, NM E0371 MATTRESS LENGTH AND WIDTH RR $246.20
Albuquerque, NM E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $227.48
Albuquerque, NM E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $290.59
Allentown-Bethlehem-Easton, PA-
NJ E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $652.43
Allentown-Bethlehem-Easton, PA-
NJ E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $212.31
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 4 of 33
Support Surfaces (Group 2 Mattresses and Overlays)
HCPCS
CBA Name Code HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Allentown-Bethlehem-Easton, PA- NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
NJ E0371 MATTRESS LENGTH AND WIDTH RR $246.75
Allentown-Bethlehem-Easton, PA-
NJ E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $222.40
Allentown-Bethlehem-Easton, PA-
NJ E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $323.37
Asheville, NC E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $646.00
Asheville, NC E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $209.00
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Asheville, NC E0371 MATTRESS LENGTH AND WIDTH RR $268.45
Asheville, NC E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $224.17
Asheville, NC E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $392.21
Atlanta-Sandy Springs-Marietta,
GA E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $667.21
Atlanta-Sandy Springs-Marietta,
GA E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $259.00
Atlanta-Sandy Springs-Marietta, NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
GA E0371 MATTRESS LENGTH AND WIDTH RR $280.92
Atlanta-Sandy Springs-Marietta,
GA E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $236.20
Atlanta-Sandy Springs-Marietta,
GA E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $341.32
Augusta-Richmond County, GA-SC E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $667.21
Augusta-Richmond County, GA-SC E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $230.00
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Augusta-Richmond County, GA-SC E0371 MATTRESS LENGTH AND WIDTH RR $246.89
Augusta-Richmond County, GA-SC E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $230.00
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 5 of 33
Support Surfaces (Group 2 Mattresses and Overlays)
HCPCS
CBA Name Code HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Augusta-Richmond County, GA-SC E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $305.42
Austin-Round Rock-San Marcos,
TX E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $581.91
Austin-Round Rock-San Marcos,
TX E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $252.96
Austin-Round Rock-San Marcos, NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
TX E0371 MATTRESS LENGTH AND WIDTH RR $238.10
Austin-Round Rock-San Marcos,
TX E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $208.10
Austin-Round Rock-San Marcos,
TX E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $290.00
Bakersfield-Delano, CA E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $759.80
Bakersfield-Delano, CA E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $195.12
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Bakersfield-Delano, CA E0371 MATTRESS LENGTH AND WIDTH RR $268.45
Bakersfield-Delano, CA E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $232.11
Bakersfield-Delano, CA E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $323.37
Baltimore-Towson, MD E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $618.50
Baltimore-Towson, MD E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $293.07
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Baltimore-Towson, MD E0371 MATTRESS LENGTH AND WIDTH RR $255.40
Baltimore-Towson, MD E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $240.56
Baltimore-Towson, MD E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $318.10
Baton Rouge, LA E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $675.40
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 6 of 33
Support Surfaces (Group 2 Mattresses and Overlays)
HCPCS
CBA Name Code HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Baton Rouge, LA E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $262.50
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Baton Rouge, LA E0371 MATTRESS LENGTH AND WIDTH RR $266.77
Baton Rouge, LA E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $237.35
Baton Rouge, LA E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $370.83
Beaumont-Port Arthur, TX E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $671.77
Beaumont-Port Arthur, TX E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $230.00
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Beaumont-Port Arthur, TX E0371 MATTRESS LENGTH AND WIDTH RR $246.20
Beaumont-Port Arthur, TX E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $220.00
Beaumont-Port Arthur, TX E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $305.42
Birmingham-Hoover, AL E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $675.40
Birmingham-Hoover, AL E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $262.50
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Birmingham-Hoover, AL E0371 MATTRESS LENGTH AND WIDTH RR $319.80
Birmingham-Hoover, AL E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $230.00
Birmingham-Hoover, AL E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $443.10
Boise City-Nampa, ID E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $687.50
Boise City-Nampa, ID E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $212.81
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Boise City-Nampa, ID E0371 MATTRESS LENGTH AND WIDTH RR $246.55
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 7 of 33
Support Surfaces (Group 2 Mattresses and Overlays)
HCPCS
CBA Name Code HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Boise City-Nampa, ID E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $230.00
Boise City-Nampa, ID E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $323.37
Boston-Cambridge-Quincy, MA-NH E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $563.81
Boston-Cambridge-Quincy, MA-NH E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $268.90
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Boston-Cambridge-Quincy, MA-NH E0371 MATTRESS LENGTH AND WIDTH RR $246.20
Boston-Cambridge-Quincy, MA-NH E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $224.95
Boston-Cambridge-Quincy, MA-NH E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $291.18
Bridgeport-Stamford-Norwalk, CT E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $563.81
Bridgeport-Stamford-Norwalk, CT E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $268.90
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Bridgeport-Stamford-Norwalk, CT E0371 MATTRESS LENGTH AND WIDTH RR $246.20
Bridgeport-Stamford-Norwalk, CT E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $224.95
Bridgeport-Stamford-Norwalk, CT E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $291.18
Bronx-Manhattan NY CBA E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $520.92
Bronx-Manhattan NY CBA E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $194.81
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Bronx-Manhattan NY CBA E0371 MATTRESS LENGTH AND WIDTH RR $194.23
Bronx-Manhattan NY CBA E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $182.07
Bronx-Manhattan NY CBA E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $276.16
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 8 of 33
Support Surfaces (Group 2 Mattresses and Overlays)
HCPCS
CBA Name Code HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Buffalo-Niagara Falls, NY E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $600.00
Buffalo-Niagara Falls, NY E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $223.17
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Buffalo-Niagara Falls, NY E0371 MATTRESS LENGTH AND WIDTH RR $246.60
Buffalo-Niagara Falls, NY E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $230.00
Buffalo-Niagara Falls, NY E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $291.00
Cape Coral-Fort Myers, FL E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $550.09
Cape Coral-Fort Myers, FL E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $191.91
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Cape Coral-Fort Myers, FL E0371 MATTRESS LENGTH AND WIDTH RR $243.10
Cape Coral-Fort Myers, FL E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $169.96
Cape Coral-Fort Myers, FL E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $196.72
Central-Chicago Metro CBA E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $559.41
Central-Chicago Metro CBA E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $301.19
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Central-Chicago Metro CBA E0371 MATTRESS LENGTH AND WIDTH RR $246.56
Central-Chicago Metro CBA E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $230.00
Central-Chicago Metro CBA E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $291.18
Charleston-North Charleston-
Summerville, SC E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $591.91
Charleston-North Charleston-
Summerville, SC E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $244.50
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 9 of 33
Support Surfaces (Group 2 Mattresses and Overlays)
HCPCS
CBA Name Code HCPCS Code Description Modifier 1 Modifier 2 Modifier 3 SPA
Charleston-North Charleston- NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Summerville, SC E0371 MATTRESS LENGTH AND WIDTH RR $246.20
Charleston-North Charleston-
Summerville, SC E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $235.37
Charleston-North Charleston-
Summerville, SC E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $291.55
Chattanooga, TN-GA E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $725.00
Chattanooga, TN-GA E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $262.50
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Chattanooga, TN-GA E0371 MATTRESS LENGTH AND WIDTH RR $246.20
Chattanooga, TN-GA E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $249.66
Chattanooga, TN-GA E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $332.86
Colorado Springs, CO E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $698.50
Colorado Springs, CO E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $287.78
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Colorado Springs, CO E0371 MATTRESS LENGTH AND WIDTH RR $246.20
Colorado Springs, CO E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $230.00
Colorado Springs, CO E0373 NONPOWERED ADVANCED PRESSURE REDUCING MATTRESS RR $305.42
Columbia, SC E0193 POWERED AIR FLOTATION BED (LOW AIR LOSS THERAPY) RR $620.00
Columbia, SC E0277 POWERED PRESSURE-REDUCING AIR MATTRESS RR $259.00
NONPOWERED ADVANCED PRESSURE REDUCING OVERLAY FOR MATTRESS, STANDARD
Columbia, SC E0371 MATTRESS LENGTH AND WIDTH RR $246.20
Columbia, SC E0372 POWERED AIR OVERLAY FOR MATTRESS, STANDARD MATTRESS LENGTH AND WIDTH RR $249.66
DMEPOS Competitive Bidding Program Round 2 SPA - Effective July 01, 2013 Page 10 of 33