| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
4,923 |
3,862 |
$31K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
593 |
413 |
$29K |
| K0002 |
Standard hemi (low seat) wheelchair |
5,728 |
4,749 |
$20K |
| K0003 |
Lightweight wheelchair |
4,883 |
3,573 |
$20K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
489 |
398 |
$14K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,529 |
1,340 |
$9K |
| K0007 |
Extra heavy duty wheelchair |
539 |
420 |
$8K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
10,390 |
8,742 |
$8K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
708 |
202 |
$6K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,556 |
614 |
$6K |
| K0006 |
Heavy duty wheelchair |
656 |
455 |
$4K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
1,304 |
467 |
$3K |
| K0816 |
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds |
188 |
171 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
256 |
215 |
$3K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
16 |
15 |
$2K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
33 |
26 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
488 |
358 |
$1K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
78 |
63 |
$1K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
418 |
320 |
$1K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
154 |
107 |
$642.20 |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
59 |
53 |
$297.31 |
| K0004 |
High strength, lightweight wheelchair |
67 |
37 |
$274.02 |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
49 |
49 |
$251.07 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
44 |
28 |
$231.36 |
| E0156 |
Seat attachment, walker |
13 |
13 |
$156.59 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
73 |
65 |
$0.00 |