| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
273 |
164 |
$22K |
| K0003 |
Lightweight wheelchair |
598 |
470 |
$14K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
873 |
551 |
$12K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
384 |
241 |
$9K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
548 |
213 |
$8K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
548 |
209 |
$5K |
| K0002 |
Standard hemi (low seat) wheelchair |
385 |
218 |
$5K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
158 |
116 |
$4K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
600 |
218 |
$3K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
18 |
13 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
238 |
151 |
$2K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
103 |
64 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
281 |
176 |
$2K |
| E1240 |
Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest |
407 |
301 |
$2K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
14 |
13 |
$2K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
1,486 |
857 |
$1K |
| E0185 |
Gel or gel-like pressure pad for mattress, standard mattress length and width |
36 |
25 |
$1K |
| E0165 |
Commode chair, mobile or stationary, with detachable arms |
42 |
25 |
$935.07 |
| E0294 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, with mattress |
53 |
37 |
$456.84 |