| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
3,923 |
2,263 |
$851K |
| E1399 |
Durable medical equipment mi |
287 |
221 |
$305K |
| E0240 |
Bath/shower chair |
89 |
87 |
$161K |
| K0739 |
Repair/svc dme non-oxygen eq |
2,850 |
2,714 |
$124K |
| E1028 |
W/c manual swingaway |
434 |
339 |
$85K |
| E0973 |
W/ch access det adj armrest |
71 |
62 |
$11K |
| E0960 |
W/c shoulder harness/straps |
140 |
103 |
$9K |
| K0040 |
Adjustable angle footplate |
83 |
67 |
$9K |
| E0956 |
W/c lateral trunk/hip suppor |
51 |
39 |
$8K |
| E0955 |
Cushioned headrest |
72 |
63 |
$6K |
| E0971 |
Wheelchair anti-tipping devi |
37 |
29 |
$3K |
| E0950 |
Tray |
12 |
12 |
$901.14 |
| E0978 |
W/c acc,saf belt pelv strap |
38 |
25 |
$832.93 |