| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
6,826 |
2,369 |
$1.15M |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
5,169 |
4,476 |
$261K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
41 |
37 |
$217K |
| K0005 |
Ultralightweight wheelchair |
101 |
98 |
$185K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,611 |
1,084 |
$179K |
| E2311 |
Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware |
72 |
67 |
$115K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
170 |
166 |
$91K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,816 |
1,769 |
$81K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
657 |
629 |
$52K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
58 |
54 |
$45K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
452 |
362 |
$44K |
| K0040 |
Adjustable angle footplate, each |
488 |
388 |
$39K |
| E0601 |
Continuous positive airway pressure (cpap) device |
1,205 |
1,130 |
$37K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
165 |
153 |
$32K |
| A4927 |
Gloves, non-sterile, per 100 |
1,026 |
990 |
$21K |
| T4534 |
Youth sized disposable incontinence product, protective underwear/pull-on, each |
162 |
158 |
$21K |
| E2363 |
Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
77 |
71 |
$20K |
| T4522 |
Adult sized disposable incontinence product, brief/diaper, medium, each |
102 |
98 |
$18K |
| E2298 |
Complex rehabilitative power wheelchair accessory, power seat elevation system, any type |
12 |
12 |
$17K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
27 |
24 |
$17K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
56 |
52 |
$16K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
41 |
40 |
$16K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
320 |
257 |
$15K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
358 |
286 |
$15K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
55 |
52 |
$12K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,174 |
1,111 |
$11K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
183 |
179 |
$7K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
65 |
63 |
$6K |
| A7031 |
Face mask interface, replacement for full face mask, each |
140 |
136 |
$5K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
205 |
192 |
$5K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
122 |
99 |
$4K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
226 |
167 |
$4K |
| E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
14 |
12 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
934 |
915 |
$4K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
25 |
24 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
51 |
50 |
$3K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
12 |
12 |
$2K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
29 |
27 |
$2K |
| A7035 |
Headgear used with positive airway pressure device |
96 |
93 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
12 |
12 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
25 |
25 |
$336.86 |