| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0001 |
Standard wheelchair |
5,624 |
3,903 |
$95K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,275 |
1,597 |
$94K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,498 |
973 |
$92K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
6,357 |
4,438 |
$53K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
1,220 |
861 |
$48K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
674 |
440 |
$26K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
855 |
704 |
$26K |
| E0570 |
Nebulizer, with compressor |
2,039 |
1,074 |
$20K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
798 |
455 |
$19K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
997 |
668 |
$12K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
514 |
363 |
$6K |
| E1238 |
Wheelchair, pediatric size, folding, adjustable, without seating system |
28 |
24 |
$3K |
| K0003 |
Lightweight wheelchair |
121 |
91 |
$3K |
| 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 |
144 |
98 |
$3K |
| K0040 |
Adjustable angle footplate, each |
323 |
157 |
$2K |
| E0156 |
Seat attachment, walker |
193 |
120 |
$1K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
41 |
24 |
$1K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
44 |
24 |
$855.35 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
113 |
75 |
$130.74 |
| A7015 |
Aerosol mask, used with dme nebulizer |
36 |
27 |
$27.71 |