| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0001 |
Standard wheelchair |
5,945 |
5,028 |
$125K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
423 |
328 |
$92K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
2,094 |
1,827 |
$84K |
| E0247 |
Transfer bench for tub or toilet with or without commode opening |
546 |
492 |
$47K |
| E0118 |
Crutch substitute, lower leg platform, with or without wheels, each |
875 |
528 |
$31K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
5,137 |
4,347 |
$31K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
471 |
367 |
$29K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
668 |
588 |
$23K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
481 |
399 |
$22K |
| E0245 |
Tub stool or bench |
437 |
389 |
$19K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
437 |
349 |
$13K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
612 |
467 |
$11K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
65 |
60 |
$5K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
75 |
68 |
$4K |
| K0007 |
Extra heavy duty wheelchair |
27 |
25 |
$2K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
16 |
13 |
$2K |
| E0156 |
Seat attachment, walker |
125 |
114 |
$2K |
| A4554 |
Disposable underpads, all sizes |
18 |
14 |
$811.60 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
42 |
41 |
$696.46 |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
13 |
12 |
$648.68 |
| E0570 |
Nebulizer, with compressor |
13 |
13 |
$549.90 |