| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
21,929 |
19,821 |
$1.66M |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
9,650 |
9,203 |
$1.31M |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
23,106 |
22,142 |
$773K |
| K0003 |
Lightweight wheelchair |
18,767 |
17,527 |
$721K |
| K0002 |
Standard hemi (low seat) wheelchair |
24,004 |
22,920 |
$683K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
5,122 |
4,398 |
$622K |
| 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 |
19,075 |
17,465 |
$439K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
1,950 |
1,825 |
$394K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
2,391 |
1,914 |
$300K |
| E0373 |
Nonpowered advanced pressure reducing mattress |
953 |
912 |
$282K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
7,441 |
7,178 |
$266K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
8,139 |
5,020 |
$226K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
64 |
54 |
$185K |
| K0007 |
Extra heavy duty wheelchair |
2,364 |
2,110 |
$177K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
3,168 |
1,837 |
$175K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
854 |
718 |
$162K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
1,961 |
1,806 |
$162K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
4,607 |
3,981 |
$161K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
2,828 |
2,710 |
$145K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
8,105 |
4,764 |
$141K |
| K0006 |
Heavy duty wheelchair |
2,773 |
2,603 |
$137K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
2,540 |
2,416 |
$130K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,416 |
2,290 |
$122K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
1,359 |
1,287 |
$120K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,167 |
644 |
$113K |
| 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 |
907 |
871 |
$102K |
| 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 |
110 |
83 |
$100K |
| E0277 |
Powered pressure-reducing air mattress |
1,074 |
1,039 |
$99K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
5,515 |
4,697 |
$98K |
| K0004 |
High strength, lightweight wheelchair |
2,105 |
1,977 |
$94K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
1,553 |
1,376 |
$92K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
2,200 |
1,881 |
$83K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
31,072 |
30,262 |
$73K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
673 |
536 |
$67K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
33 |
27 |
$65K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
1,589 |
1,531 |
$55K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
807 |
691 |
$42K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
2,412 |
2,128 |
$29K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
147 |
139 |
$22K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
386 |
282 |
$20K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
1,587 |
1,498 |
$18K |
| E2397 |
Power wheelchair accessory, lithium-based battery, each |
113 |
95 |
$15K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
56 |
43 |
$11K |
| E2622 |
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
71 |
66 |
$9K |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
434 |
432 |
$7K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
346 |
337 |
$7K |
| E0156 |
Seat attachment, walker |
688 |
637 |
$6K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
38 |
27 |
$6K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
36 |
29 |
$5K |
| E0244 |
Raised toilet seat |
198 |
191 |
$5K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
36 |
29 |
$4K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
31 |
25 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
123 |
108 |
$2K |
| K0040 |
Adjustable angle footplate, each |
31 |
25 |
$1K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
100 |
100 |
$1K |
| E2612 |
General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware |
17 |
13 |
$991.07 |
| E1020 |
Residual limb support system for wheelchair, any type |
15 |
14 |
$800.75 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
25 |
15 |
$418.29 |
| E2602 |
General use wheelchair seat cushion, width 22 inches or greater, any depth |
16 |
12 |
$196.24 |