| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
449 |
171 |
$63K |
| K0001 |
Standard wheelchair |
1,527 |
1,514 |
$26K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
562 |
506 |
$24K |
| E1399 |
Durable medical equipment, miscellaneous |
62 |
14 |
$20K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
286 |
286 |
$15K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
541 |
538 |
$14K |
| K0007 |
Extra heavy duty wheelchair |
176 |
174 |
$10K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
270 |
268 |
$10K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
84 |
84 |
$7K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
179 |
178 |
$6K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
247 |
246 |
$6K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
75 |
75 |
$6K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
164 |
164 |
$6K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
165 |
163 |
$6K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
271 |
267 |
$5K |
| K0006 |
Heavy duty wheelchair |
86 |
86 |
$4K |
| K0003 |
Lightweight wheelchair |
274 |
272 |
$4K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
528 |
518 |
$4K |
| K0040 |
Adjustable angle footplate, each |
40 |
40 |
$3K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
16 |
15 |
$2K |
| E0601 |
Continuous positive airway pressure (cpap) device |
457 |
456 |
$2K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
50 |
50 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
76 |
76 |
$2K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
72 |
72 |
$2K |
| A7030 |
Full face mask used with positive airway pressure device, each |
54 |
54 |
$1K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
98 |
97 |
$1K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
12 |
12 |
$1K |
| E0570 |
Nebulizer, with compressor |
39 |
39 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
205 |
204 |
$1K |
| E0700 |
Safety equipment, device or accessory, any type |
13 |
13 |
$1K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
41 |
41 |
$1K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
95 |
94 |
$1K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
76 |
74 |
$988.03 |
| A7035 |
Headgear used with positive airway pressure device |
200 |
199 |
$801.16 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
124 |
124 |
$739.07 |
| E0156 |
Seat attachment, walker |
93 |
88 |
$496.34 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
288 |
286 |
$303.66 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
12 |
12 |
$140.40 |
| A7046 |
Water chamber for humidifier, used with positive airway pressure device, replacement, each |
54 |
54 |
$129.48 |