| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
19,562 |
19,110 |
$313K |
| K0003 |
Lightweight wheelchair |
18,616 |
18,052 |
$257K |
| E0277 |
Powered pressure-reducing air mattress |
2,765 |
2,693 |
$174K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
5,432 |
3,585 |
$135K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
5,450 |
3,583 |
$133K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
363 |
354 |
$129K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
2,236 |
2,134 |
$82K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
4,697 |
4,574 |
$80K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,587 |
1,448 |
$70K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
1,125 |
1,040 |
$62K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,191 |
2,018 |
$43K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
3,162 |
3,035 |
$40K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
2,340 |
2,151 |
$31K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
1,385 |
1,273 |
$21K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
903 |
847 |
$21K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
613 |
590 |
$17K |
| K0007 |
Extra heavy duty wheelchair |
494 |
443 |
$16K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
861 |
811 |
$15K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
1,582 |
1,478 |
$12K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
5,401 |
5,148 |
$10K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
2,920 |
2,804 |
$9K |
| K0006 |
Heavy duty wheelchair |
499 |
483 |
$9K |
| E2202 |
Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches |
421 |
373 |
$8K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
655 |
624 |
$6K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
1,066 |
1,046 |
$3K |
| K0001 |
Standard wheelchair |
108 |
105 |
$2K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
723 |
686 |
$2K |
| E0156 |
Seat attachment, walker |
301 |
291 |
$2K |
| E2622 |
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
12 |
12 |
$930.51 |