| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
6,185 |
2,284 |
$591K |
| E1399 |
Durable medical equipment, miscellaneous |
880 |
250 |
$510K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
4,465 |
3,607 |
$403K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
2,840 |
2,034 |
$367K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
7,424 |
6,393 |
$302K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
1,165 |
935 |
$189K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
7,990 |
3,701 |
$169K |
| K0001 |
Standard wheelchair |
10,433 |
8,479 |
$156K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
3,146 |
2,721 |
$93K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
2,103 |
1,660 |
$91K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
6,079 |
4,727 |
$89K |
| E0277 |
Powered pressure-reducing air mattress |
497 |
422 |
$83K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
632 |
533 |
$80K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,891 |
1,327 |
$68K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
3,629 |
2,649 |
$62K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
9,734 |
7,739 |
$60K |
| E0601 |
Continuous positive airway pressure (cpap) device |
831 |
732 |
$60K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
549 |
470 |
$53K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
12 |
12 |
$50K |
| K0006 |
Heavy duty wheelchair |
1,324 |
1,059 |
$46K |
| K0003 |
Lightweight wheelchair |
1,344 |
1,082 |
$38K |
| E0570 |
Nebulizer, with compressor |
1,497 |
1,306 |
$35K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
12 |
12 |
$33K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,248 |
1,115 |
$33K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
863 |
821 |
$26K |
| A7030 |
Full face mask used with positive airway pressure device, each |
356 |
341 |
$24K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
475 |
379 |
$23K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,124 |
747 |
$21K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
910 |
784 |
$20K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
50 |
41 |
$17K |
| 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 |
13 |
12 |
$14K |
| A7035 |
Headgear used with positive airway pressure device |
907 |
862 |
$13K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
445 |
414 |
$12K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
639 |
556 |
$12K |
| K0005 |
Ultralightweight wheelchair |
13 |
12 |
$11K |
| E0301 |
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, without mattress |
223 |
197 |
$11K |
| K0040 |
Adjustable angle footplate, each |
284 |
191 |
$10K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
89 |
77 |
$9K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
30 |
24 |
$7K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
571 |
470 |
$6K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
393 |
286 |
$6K |
| E2622 |
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
50 |
41 |
$5K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
28 |
24 |
$5K |
| A7031 |
Face mask interface, replacement for full face mask, each |
147 |
138 |
$5K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
243 |
206 |
$4K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
14 |
12 |
$4K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
667 |
567 |
$4K |
| E0156 |
Seat attachment, walker |
447 |
379 |
$3K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,451 |
1,208 |
$3K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
645 |
484 |
$3K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
29 |
26 |
$3K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
362 |
317 |
$3K |
| E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
14 |
12 |
$2K |
| 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 |
50 |
36 |
$2K |
| E2392 |
Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each |
55 |
38 |
$2K |
| E2219 |
Manual wheelchair accessory, foam caster tire, any size, each |
50 |
41 |
$2K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
55 |
40 |
$2K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
84 |
77 |
$2K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
18 |
12 |
$2K |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
40 |
26 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
124 |
95 |
$2K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
82 |
54 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
110 |
84 |
$1K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
16 |
12 |
$1K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
58 |
41 |
$1K |
| K0019 |
Arm pad, replacement only, each |
187 |
125 |
$1K |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
103 |
98 |
$1K |
| E2395 |
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
13 |
13 |
$922.15 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
14 |
14 |
$482.56 |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
21 |
14 |
$402.12 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
208 |
194 |
$370.76 |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
20 |
14 |
$328.83 |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
38 |
25 |
$236.03 |
| A7002 |
Tubing, used with suction pump, each |
40 |
26 |
$208.77 |
| A7015 |
Aerosol mask, used with dme nebulizer |
137 |
129 |
$174.32 |
| E2210 |
Wheelchair accessory, bearings, any type, replacement only, each |
15 |
14 |
$127.69 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
16 |
12 |
$95.74 |
| A7000 |
Canister, disposable, used with suction pump, each |
40 |
26 |
$86.13 |