| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
180 |
178 |
$374K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
6,022 |
5,995 |
$138K |
| E2311 |
Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware |
208 |
206 |
$109K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
923 |
923 |
$69K |
| K0001 |
Standard wheelchair |
6,068 |
6,044 |
$61K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,734 |
1,146 |
$47K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
937 |
925 |
$45K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
642 |
639 |
$37K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
485 |
481 |
$30K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,252 |
1,250 |
$28K |
| E0310 |
Bed side rails, full length |
732 |
727 |
$25K |
| E0272 |
Mattress, foam rubber |
722 |
717 |
$25K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,225 |
1,192 |
$23K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
200 |
197 |
$23K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
148 |
146 |
$23K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,653 |
1,111 |
$21K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
612 |
351 |
$18K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
885 |
867 |
$18K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
219 |
215 |
$11K |
| E2359 |
Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
124 |
122 |
$11K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
2,034 |
2,032 |
$10K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
875 |
865 |
$10K |
| K0005 |
Ultralightweight wheelchair |
14 |
13 |
$9K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
1,108 |
1,094 |
$9K |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
1,086 |
1,074 |
$8K |
| K0040 |
Adjustable angle footplate, each |
504 |
259 |
$7K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,376 |
1,352 |
$6K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
229 |
227 |
$6K |
| E0245 |
Tub stool or bench |
96 |
95 |
$5K |
| E1225 |
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each |
482 |
466 |
$5K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
53 |
53 |
$4K |
| E0156 |
Seat attachment, walker |
597 |
590 |
$3K |
| K0006 |
Heavy duty wheelchair |
38 |
38 |
$3K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
14 |
14 |
$2K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
33 |
32 |
$2K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
284 |
284 |
$1K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
15 |
15 |
$1K |
| E0305 |
Bed side rails, half length |
259 |
259 |
$1K |
| E2219 |
Manual wheelchair accessory, foam caster tire, any size, each |
59 |
57 |
$1K |
| E2218 |
Manual wheelchair accessory, foam propulsion tire, any size, each |
13 |
12 |
$407.50 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
44 |
42 |
$339.67 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
14 |
13 |
$327.52 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
43 |
42 |
$260.37 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
12 |
12 |
$32.88 |