| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
96 |
93 |
$366K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
400 |
139 |
$191K |
| K0001 |
Standard wheelchair |
5,335 |
5,273 |
$147K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
1,798 |
1,775 |
$106K |
| K0003 |
Lightweight wheelchair |
1,876 |
1,835 |
$74K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,746 |
1,692 |
$65K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
918 |
901 |
$53K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,074 |
1,057 |
$48K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
4,900 |
4,533 |
$41K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
181 |
76 |
$30K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,020 |
1,990 |
$27K |
| E0305 |
Bed side rails, half length |
1,293 |
1,275 |
$19K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
349 |
343 |
$17K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
3,335 |
3,263 |
$15K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
332 |
316 |
$14K |
| E0271 |
Mattress, innerspring |
592 |
589 |
$10K |
| K0040 |
Adjustable angle footplate, each |
125 |
112 |
$10K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
61 |
61 |
$3K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
48 |
48 |
$3K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
14 |
12 |
$3K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
37 |
37 |
$2K |
| E0310 |
Bed side rails, full length |
102 |
102 |
$2K |
| K0006 |
Heavy duty wheelchair |
25 |
25 |
$2K |
| E0245 |
Tub stool or bench |
38 |
38 |
$2K |
| E0156 |
Seat attachment, walker |
119 |
118 |
$1K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
116 |
108 |
$886.66 |
| E2209 |
Accessory, arm trough, with or without hand support, each |
68 |
66 |
$631.28 |
| E0240 |
Bath/shower chair, with or without wheels, any size |
14 |
13 |
$291.06 |