| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
7,901 |
5,929 |
$2.10M |
| E0240 |
Bath/shower chair |
695 |
630 |
$1.10M |
| E1028 |
W/c manual swingaway |
3,629 |
2,832 |
$663K |
| E2617 |
Custom fab w/c back cushion |
438 |
431 |
$454K |
| E1399 |
Durable medical equipment mi |
647 |
510 |
$407K |
| K0739 |
Repair/svc dme non-oxygen eq |
6,835 |
6,591 |
$368K |
| E2609 |
Custom fabricate w/c cushion |
400 |
383 |
$339K |
| E0973 |
W/ch access det adj armrest |
2,125 |
1,760 |
$275K |
| E0956 |
W/c lateral trunk/hip suppor |
1,349 |
1,080 |
$271K |
| E0955 |
Cushioned headrest |
1,851 |
1,810 |
$167K |
| K0040 |
Adjustable angle footplate |
1,499 |
1,376 |
$156K |
| K0823 |
Pwc gp 2 std cap chair |
102 |
97 |
$140K |
| E0960 |
W/c shoulder harness/straps |
1,619 |
1,374 |
$120K |
| E0971 |
Wheelchair anti-tipping devi |
1,496 |
1,287 |
$109K |
| E8000 |
Posterior gait trainer |
64 |
64 |
$81K |
| K0005 |
Ultralightweight wheelchair |
50 |
50 |
$77K |
| K0800 |
Pov group 1 std up to 300lbs |
53 |
53 |
$61K |
| E1161 |
Manual adult wc w tiltinspac |
67 |
67 |
$46K |
| E2607 |
Skin pro/pos wc cus wd <22in |
180 |
174 |
$40K |
| E2613 |
Position back cush wd <22in |
107 |
97 |
$35K |
| E0978 |
W/c acc,saf belt pelv strap |
1,088 |
1,014 |
$30K |
| E2213 |
Pneumatic prop tire insert |
721 |
709 |
$24K |
| E0950 |
Tray |
130 |
108 |
$9K |
| E0630 |
Patient lift hydraulic |
50 |
40 |
$8K |
| E0951 |
Loop heel |
157 |
151 |
$4K |
| E2211 |
Pneumatic propulsion tire |
77 |
76 |
$4K |
| K0038 |
Leg strap each |
73 |
73 |
$2K |
| E0957 |
W/c medial thigh support |
12 |
12 |
$1K |
| E0961 |
Wheelchair brake extension |
14 |
14 |
$607.60 |