| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
8,490 |
6,158 |
$159K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,662 |
1,345 |
$158K |
| K0001 |
Standard wheelchair |
10,953 |
8,709 |
$142K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
596 |
488 |
$129K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
4,221 |
3,248 |
$69K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
7,126 |
5,498 |
$63K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
4,101 |
2,927 |
$63K |
| E0266 |
Hospital bed, total electric (head, foot and height adjustments), with any type side rails, without mattress |
115 |
55 |
$55K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
2,276 |
1,801 |
$50K |
| K0007 |
Extra heavy duty wheelchair |
599 |
448 |
$38K |
| K0003 |
Lightweight wheelchair |
2,491 |
1,935 |
$38K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,212 |
1,874 |
$33K |
| K0006 |
Heavy duty wheelchair |
672 |
534 |
$29K |
| E0277 |
Powered pressure-reducing air mattress |
208 |
144 |
$26K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
606 |
452 |
$22K |
| E0184 |
Dry pressure mattress |
537 |
390 |
$17K |
| E0570 |
Nebulizer, with compressor |
1,499 |
1,082 |
$16K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
801 |
655 |
$13K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
259 |
178 |
$11K |
| E0156 |
Seat attachment, walker |
1,465 |
1,276 |
$10K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
886 |
710 |
$10K |
| E0910 |
Trapeze bars, a/k/a patient helper, attached to bed, with grab bar |
864 |
623 |
$8K |
| E0149 |
Walker, heavy duty, wheeled, rigid or folding, any type |
898 |
764 |
$8K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
194 |
138 |
$7K |
| T4541 |
Incontinence product, disposable underpad, large, each |
243 |
201 |
$4K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
30 |
24 |
$3K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
39 |
25 |
$3K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
88 |
40 |
$3K |
| K0462 |
Temporary replacement for patient owned equipment being repaired, any type |
84 |
56 |
$2K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
32 |
25 |
$2K |
| E2395 |
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
80 |
53 |
$2K |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
86 |
38 |
$1K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
12 |
12 |
$1K |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
654 |
464 |
$1K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
263 |
170 |
$1K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
14 |
12 |
$1K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
448 |
368 |
$1K |
| E2387 |
Power wheelchair accessory, foam filled caster tire, any size, replacement only, each |
62 |
40 |
$1K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
31 |
24 |
$1K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
13 |
12 |
$561.16 |
| E0305 |
Bed side rails, half length |
86 |
60 |
$100.82 |