| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
564 |
197 |
$15K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
141 |
29 |
$9K |
| K0001 |
Standard wheelchair |
2,036 |
1,667 |
$8K |
| K0003 |
Lightweight wheelchair |
219 |
179 |
$5K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
247 |
164 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
329 |
266 |
$3K |
| E0601 |
Continuous positive airway pressure (cpap) device |
124 |
107 |
$2K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
104 |
62 |
$2K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
154 |
136 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
28 |
24 |
$325.42 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
187 |
160 |
$285.43 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
44 |
37 |
$265.91 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
138 |
99 |
$257.86 |