| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
3,542 |
3,458 |
$460K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
8,895 |
8,619 |
$268K |
| K0003 |
Lightweight wheelchair |
6,809 |
6,498 |
$199K |
| K0002 |
Standard hemi (low seat) wheelchair |
9,368 |
8,990 |
$179K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
1,661 |
1,478 |
$160K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
2,465 |
2,316 |
$111K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
2,068 |
2,018 |
$65K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,879 |
1,719 |
$62K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,083 |
645 |
$55K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,080 |
1,026 |
$45K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
1,472 |
1,306 |
$43K |
| K0004 |
High strength, lightweight wheelchair |
659 |
621 |
$37K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
723 |
702 |
$35K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
2,721 |
1,515 |
$33K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
13,682 |
13,399 |
$32K |
| K0006 |
Heavy duty wheelchair |
579 |
549 |
$27K |
| 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 |
1,900 |
1,772 |
$27K |
| K0007 |
Extra heavy duty wheelchair |
346 |
291 |
$26K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,785 |
1,561 |
$25K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
612 |
600 |
$25K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
270 |
237 |
$22K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
77 |
75 |
$19K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
452 |
404 |
$15K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
94 |
87 |
$13K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
124 |
102 |
$11K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
155 |
129 |
$8K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
713 |
638 |
$8K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
62 |
50 |
$7K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
27 |
27 |
$3K |
| E0156 |
Seat attachment, walker |
235 |
218 |
$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 |
25 |
24 |
$2K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
68 |
63 |
$2K |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
66 |
66 |
$769.92 |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
23 |
15 |
$586.27 |