| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
2,569 |
2,554 |
$178K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
20,375 |
20,038 |
$56K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
1,000 |
968 |
$47K |
| A4670 |
Automatic blood pressure monitor |
274 |
274 |
$34K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
4,940 |
4,832 |
$18K |
| K0001 |
Standard wheelchair |
1,066 |
1,061 |
$18K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
530 |
501 |
$15K |
| K0003 |
Lightweight wheelchair |
850 |
843 |
$15K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,024 |
837 |
$13K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
439 |
435 |
$10K |
| L3916 |
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
80 |
76 |
$9K |
| L2810 |
Addition to lower extremity orthosis, knee control, condylar pad |
1,084 |
1,053 |
$8K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
731 |
607 |
$5K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
1,078 |
1,048 |
$5K |
| L2795 |
Addition to lower extremity orthosis, knee control, full kneecap |
1,051 |
1,021 |
$5K |
| E0570 |
Nebulizer, with compressor |
251 |
246 |
$4K |
| E0720 |
Transcutaneous electrical nerve stimulation (tens) device, two lead, localized stimulation |
26 |
26 |
$4K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
187 |
182 |
$4K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
725 |
609 |
$3K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
409 |
401 |
$3K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
790 |
656 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
537 |
524 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
366 |
365 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
880 |
880 |
$1K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
25 |
25 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
202 |
196 |
$886.00 |
| E0245 |
Tub stool or bench |
109 |
109 |
$720.82 |
| E0156 |
Seat attachment, walker |
315 |
308 |
$683.56 |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
29 |
29 |
$415.93 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
39 |
39 |
$240.98 |
| A4557 |
Lead wires, (e.g., apnea monitor), per pair |
12 |
12 |
$180.00 |
| A7015 |
Aerosol mask, used with dme nebulizer |
290 |
277 |
$49.50 |