| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2228 |
Mwc acc, wheelchair brake |
120,828 |
42,440 |
$990K |
| E2627 |
Arm supp att to wc rancho ty |
13,043 |
4,236 |
$967K |
| K0001 |
Standard wheelchair |
62,881 |
41,305 |
$518K |
| E0260 |
Hosp bed semi-electr w/ matt |
20,030 |
12,721 |
$232K |
| E2606 |
Position wc cush wdth>=22 in |
5,518 |
3,306 |
$183K |
| K0006 |
Heavy duty wheelchair |
5,390 |
3,652 |
$101K |
| E2613 |
Position back cush wd <22in |
4,263 |
2,482 |
$73K |
| E0630 |
Patient lift hydraulic |
8,598 |
5,571 |
$72K |
| K0003 |
Lightweight wheelchair |
4,243 |
2,771 |
$51K |
| K0007 |
Extra heavy duty wheelchair |
2,037 |
1,387 |
$50K |
| E1390 |
Oxygen concentrator |
2,151 |
1,423 |
$46K |
| E0163 |
Commode chair with fixed arm |
4,443 |
2,835 |
$44K |
| E0951 |
Loop heel |
11,713 |
3,997 |
$43K |
| E0141 |
Rigid wheeled walker adj/fix |
3,818 |
2,516 |
$41K |
| E0973 |
W/ch access det adj armrest |
13,411 |
4,296 |
$38K |
| E0185 |
Gel pressure mattress pad |
2,351 |
1,392 |
$33K |
| E2631 |
Elevat proximal arm support |
3,636 |
1,127 |
$29K |
| E0295 |
Hosp bed semi-elect w/o matt |
8,328 |
6,131 |
$27K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
1,628 |
952 |
$26K |
| E0303 |
Hosp bed hvy dty xtra wide |
656 |
421 |
$25K |
| E0570 |
Nebulizer with compression |
4,657 |
3,180 |
$21K |
| E0140 |
Walker w trunk support |
19,765 |
13,824 |
$17K |
| K0195 |
Elevating whlchair leg rests |
17,011 |
10,936 |
$17K |
| E0261 |
Hosp bed semi-electr w/o mat |
4,572 |
3,122 |
$11K |
| E0271 |
Mattress innerspring |
1,517 |
948 |
$10K |
| E0971 |
Wheelchair anti-tipping devi |
3,980 |
1,241 |
$8K |
| E0955 |
Cushioned headrest |
2,153 |
1,406 |
$8K |
| K0004 |
High strength ltwt whlchr |
769 |
557 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
318 |
250 |
$7K |
| E0159 |
Brake for wheeled walker |
4,547 |
1,613 |
$6K |
| E0988 |
Lever-activated wheel drive |
661 |
460 |
$6K |
| E2611 |
Gen use back cush wdth <22in |
260 |
180 |
$6K |
| E0255 |
Hospital bed var ht w/ mattr |
125 |
122 |
$5K |
| E0371 |
Nonpower mattress overlay |
2,589 |
1,779 |
$5K |
| E0156 |
Walker seat attachment |
2,679 |
1,772 |
$5K |
| K0002 |
Stnd hemi (low seat) whlchr |
211 |
174 |
$4K |
| E0974 |
W/ch access anti-rollback |
458 |
161 |
$2K |
| K0040 |
Adjustable angle footplate |
465 |
162 |
$2K |
| E2601 |
Gen w/c cushion wdth < 22 in |
306 |
220 |
$2K |
| E2614 |
Position back cush wd>=22in |
147 |
129 |
$2K |
| E0310 |
Rails bed side full length |
846 |
561 |
$2K |
| E0165 |
Commode chair with detacharm |
489 |
309 |
$1K |
| E0277 |
Powered pres-redu air mattrs |
152 |
116 |
$1K |
| E0940 |
Trapeze bar free standing |
325 |
205 |
$999.60 |
| E0990 |
Wheelchair elevating leg res |
344 |
158 |
$967.68 |
| K0065 |
Spoke protectors |
469 |
162 |
$574.36 |
| K0823 |
Pwc gp 2 std cap chair |
37 |
27 |
$569.24 |
| K0038 |
Leg strap each |
476 |
165 |
$317.74 |
| A7005 |
Nondisposable nebulizer set |
37 |
25 |
$67.32 |
| E0372 |
Powered air mattress overlay |
369 |
339 |
$38.44 |
| E0978 |
W/c acc,saf belt pelv strap |
22 |
12 |
$32.73 |
| A7003 |
Nebulizer administration set |
15 |
12 |
$5.74 |
| A7013 |
Disposable compressor filter |
37 |
25 |
$1.63 |