| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
3,186 |
3,164 |
$210K |
| E1002 |
Wheelchair accessory, power seating system, tilt only |
64 |
64 |
$168K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
3,718 |
3,678 |
$133K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
1,459 |
1,439 |
$126K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
6,104 |
6,075 |
$123K |
| K0816 |
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds |
2,926 |
2,862 |
$119K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
1,495 |
1,344 |
$105K |
| K0003 |
Lightweight wheelchair |
4,771 |
4,723 |
$71K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
1,639 |
1,604 |
$66K |
| K0002 |
Standard hemi (low seat) wheelchair |
5,707 |
5,680 |
$63K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
42 |
37 |
$40K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
2,204 |
1,227 |
$38K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,943 |
1,940 |
$37K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12,095 |
12,022 |
$31K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
820 |
791 |
$29K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
824 |
716 |
$29K |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
2,963 |
2,925 |
$23K |
| 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 |
131 |
124 |
$19K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
2,427 |
2,214 |
$18K |
| E0277 |
Powered pressure-reducing air mattress |
423 |
420 |
$17K |
| K0006 |
Heavy duty wheelchair |
682 |
675 |
$15K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
52 |
50 |
$14K |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
426 |
426 |
$13K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,601 |
945 |
$13K |
| K0007 |
Extra heavy duty wheelchair |
420 |
419 |
$12K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
864 |
475 |
$11K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
255 |
177 |
$11K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
207 |
206 |
$10K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
1,300 |
694 |
$8K |
| E2310 |
Power wheelchair accessory, electronic connection between wheelchair controller and one power seating system motor, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware |
13 |
13 |
$8K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
711 |
685 |
$6K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
78 |
73 |
$5K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
245 |
245 |
$5K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
739 |
714 |
$4K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
104 |
103 |
$3K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
38 |
37 |
$3K |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
88 |
88 |
$3K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
77 |
73 |
$3K |
| K0001 |
Standard wheelchair |
348 |
348 |
$2K |
| K0004 |
High strength, lightweight wheelchair |
109 |
107 |
$2K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
12 |
12 |
$904.24 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
230 |
230 |
$820.32 |
| K0040 |
Adjustable angle footplate, each |
18 |
12 |
$341.99 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
63 |
61 |
$147.10 |
| E0156 |
Seat attachment, walker |
19 |
19 |
$123.00 |