| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
9,097 |
8,993 |
$174K |
| K0001 |
Standard wheelchair |
15,203 |
15,033 |
$163K |
| K0002 |
Standard hemi (low seat) wheelchair |
8,144 |
8,035 |
$134K |
| K0003 |
Lightweight wheelchair |
4,208 |
4,172 |
$65K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
3,651 |
3,606 |
$64K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
2,910 |
2,856 |
$59K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,651 |
1,633 |
$51K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
2,534 |
2,520 |
$43K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
2,399 |
2,376 |
$22K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,639 |
4,582 |
$16K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
158 |
157 |
$10K |
| B4035 |
Enteral feeding supply kit; pump fed, per day, includes but not limited to feeding/flushing syringe, administration set tubing, dressings, tape |
190 |
175 |
$10K |
| E0250 |
Hospital bed, fixed height, with any type side rails, with mattress |
463 |
459 |
$9K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
1,680 |
1,664 |
$9K |
| K0006 |
Heavy duty wheelchair |
208 |
206 |
$5K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
119 |
119 |
$4K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
243 |
243 |
$4K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
650 |
639 |
$3K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
183 |
174 |
$2K |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
129 |
129 |
$2K |
| E0156 |
Seat attachment, walker |
484 |
479 |
$2K |
| E0776 |
Iv pole |
156 |
151 |
$1K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
198 |
197 |
$1K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
574 |
569 |
$1K |
| E0570 |
Nebulizer, with compressor |
558 |
555 |
$1K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
200 |
198 |
$943.54 |
| B4154 |
Enteral formula, nutritionally complete, for special metabolic needs, excludes inherited disease of metabolism, includes altered composition of proteins, fats, carbohydrates, vitamins and/or minerals, may include fiber, administered through an enteral feeding tube, 100 calories = 1 unit |
14 |
13 |
$742.61 |
| K0007 |
Extra heavy duty wheelchair |
12 |
12 |
$500.01 |
| E0271 |
Mattress, innerspring |
12 |
12 |
$359.39 |
| E0310 |
Bed side rails, full length |
12 |
12 |
$349.23 |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
49 |
49 |
$312.70 |
| E0966 |
Manual wheelchair accessory, headrest extension, each |
74 |
74 |
$134.49 |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
46 |
46 |
$124.03 |