| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1220 |
Wheelchair; specially sized or constructed, (indicate brand name, model number, if any) and justification |
731 |
571 |
$4.71M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
2,131 |
1,225 |
$2.59M |
| E1399 |
Durable medical equipment, miscellaneous |
591 |
428 |
$1.91M |
| E0240 |
Bath/shower chair, with or without wheels, any size |
334 |
251 |
$495K |
| K0005 |
Ultralightweight wheelchair |
191 |
163 |
$256K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
885 |
598 |
$87K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,900 |
1,618 |
$80K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
675 |
497 |
$60K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
323 |
257 |
$50K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
156 |
129 |
$35K |
| K0040 |
Adjustable angle footplate, each |
400 |
307 |
$34K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
478 |
351 |
$24K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,388 |
689 |
$21K |
| E0265 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, with mattress |
13 |
12 |
$14K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
213 |
193 |
$12K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
844 |
595 |
$7K |
| A7037 |
Tubing used with positive airway pressure device |
422 |
369 |
$7K |
| A7035 |
Headgear used with positive airway pressure device |
396 |
346 |
$7K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
148 |
127 |
$6K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
248 |
215 |
$5K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
32 |
24 |
$4K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
178 |
138 |
$4K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
71 |
56 |
$3K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
54 |
38 |
$2K |
| E2219 |
Manual wheelchair accessory, foam caster tire, any size, each |
30 |
26 |
$2K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
676 |
395 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
70 |
55 |
$1K |
| E2363 |
Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
19 |
12 |
$1K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
236 |
183 |
$897.87 |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
14 |
12 |
$355.36 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
43 |
38 |
$219.22 |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
14 |
12 |
$144.28 |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
15 |
13 |
$0.00 |