| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
381 |
355 |
$23K |
| K0001 |
Standard wheelchair |
2,014 |
1,850 |
$14K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
539 |
474 |
$12K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
142 |
118 |
$10K |
| E0245 |
Tub stool or bench |
133 |
93 |
$4K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
404 |
385 |
$3K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
120 |
97 |
$3K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
33 |
28 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
851 |
776 |
$2K |
| K0003 |
Lightweight wheelchair |
202 |
196 |
$2K |
| K0006 |
Heavy duty wheelchair |
130 |
128 |
$2K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
122 |
103 |
$2K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
38 |
33 |
$830.80 |
| E0156 |
Seat attachment, walker |
60 |
46 |
$483.20 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
58 |
32 |
$410.22 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
36 |
36 |
$139.22 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
13 |
13 |
$130.70 |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
28 |
27 |
$68.61 |