| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,431 |
925 |
$58K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
3,147 |
2,128 |
$35K |
| K0001 |
Standard wheelchair |
5,628 |
3,841 |
$27K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
397 |
262 |
$20K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
1,583 |
1,008 |
$12K |
| E0255 |
Hospital bed, variable height, hi-lo, with any type side rails, with mattress |
1,143 |
704 |
$12K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,339 |
530 |
$7K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
546 |
426 |
$7K |
| K0002 |
Standard hemi (low seat) wheelchair |
867 |
508 |
$6K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
2,137 |
1,365 |
$5K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
459 |
171 |
$4K |
| K0003 |
Lightweight wheelchair |
345 |
225 |
$3K |
| E0256 |
Hospital bed, variable height, hi-lo, with any type side rails, without mattress |
1,378 |
851 |
$3K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,480 |
1,067 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
867 |
337 |
$2K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
223 |
144 |
$1K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
443 |
306 |
$1K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
339 |
171 |
$1K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
783 |
308 |
$886.32 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
653 |
254 |
$855.51 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
476 |
316 |
$527.37 |
| E0156 |
Seat attachment, walker |
243 |
199 |
$396.55 |
| E0271 |
Mattress, innerspring |
19 |
12 |
$374.37 |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
15 |
12 |
$346.39 |
| E0184 |
Dry pressure mattress |
26 |
13 |
$342.03 |
| E0277 |
Powered pressure-reducing air mattress |
17 |
12 |
$264.65 |
| K0006 |
Heavy duty wheelchair |
15 |
12 |
$158.09 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
99 |
54 |
$113.75 |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
18 |
12 |
$37.82 |