| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0004 |
High strength, lightweight wheelchair |
5,497 |
5,455 |
$126K |
| K0003 |
Lightweight wheelchair |
5,589 |
5,545 |
$90K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,882 |
2,867 |
$70K |
| 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 |
1,325 |
737 |
$32K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
344 |
343 |
$19K |
| L0642 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
230 |
230 |
$15K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
1,001 |
536 |
$14K |
| E0156 |
Seat attachment, walker |
2,557 |
2,538 |
$13K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
253 |
201 |
$12K |
| L0627 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
242 |
242 |
$9K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
811 |
805 |
$8K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
152 |
152 |
$6K |
| K0001 |
Standard wheelchair |
335 |
328 |
$3K |
| 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 |
1,319 |
737 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
153 |
153 |
$1K |
| E0210 |
Electric heat pad, standard |
12 |
12 |
$681.40 |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
104 |
104 |
$486.82 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
13 |
13 |
$423.53 |
| E0105 |
Cane, quad or three prong, includes canes of all materials, adjustable or fixed, with tips |
63 |
63 |
$347.99 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
82 |
75 |
$196.04 |