| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2228 |
Manual wheelchair accessory, wheel braking system and lock, complete, each |
660 |
317 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
572 |
521 |
$3K |
| K0001 |
Standard wheelchair |
1,089 |
931 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
266 |
254 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
668 |
562 |
$837.99 |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
15 |
15 |
$747.69 |
| E0141 |
Walker, rigid, wheeled, adjustable or fixed height |
34 |
31 |
$630.26 |
| E0140 |
Walker, with trunk support, adjustable or fixed height, any type |
335 |
306 |
$623.66 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
110 |
102 |
$451.44 |
| E0988 |
Manual wheelchair accessory, lever-activated, wheel drive, pair |
99 |
99 |
$430.80 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
34 |
17 |
$385.24 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
18 |
16 |
$264.30 |
| E0156 |
Seat attachment, walker |
29 |
29 |
$256.56 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
34 |
17 |
$236.20 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
15 |
15 |
$179.07 |
| E0159 |
Brake attachment for wheeled walker, replacement, each |
56 |
28 |
$72.15 |
| K0040 |
Adjustable angle footplate, each |
34 |
17 |
$51.98 |
| K0038 |
Leg strap, each |
34 |
17 |
$0.00 |
| E2627 |
Wheelchair accessory, shoulder elbow, mobile arm support attached to wheelchair, balanced, adjustable rancho type |
34 |
17 |
$0.00 |
| E0974 |
Manual wheelchair accessory, anti-rollback device, each |
34 |
17 |
$0.00 |
| E2631 |
Wheelchair accessory, addition to mobile arm support, elevating proximal arm |
34 |
17 |
$0.00 |
| K0065 |
Spoke protectors, each |
34 |
17 |
$0.00 |