| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0277 |
Powered pres-redu air mattrs |
10,361 |
10,061 |
$5.00M |
| E1399 |
Durable medical equipment mi |
4,923 |
2,609 |
$3.92M |
| A9900 |
Supply/accessory/service |
2,863 |
734 |
$1.16M |
| E0295 |
Hosp bed semi-elect w/o matt |
9,989 |
9,877 |
$799K |
| K0001 |
Standard wheelchair |
14,558 |
14,264 |
$616K |
| K0108 |
W/c component-accessory nos |
2,844 |
1,092 |
$480K |
| K0007 |
Extra heavy duty wheelchair |
2,643 |
2,611 |
$416K |
| E0303 |
Hosp bed hvy dty xtra wide |
1,779 |
1,757 |
$322K |
| E0304 |
Hosp bed xtra hvy dty x wide |
584 |
579 |
$266K |
| K0006 |
Heavy duty wheelchair |
2,201 |
2,155 |
$215K |
| K0003 |
Lightweight wheelchair |
3,301 |
3,218 |
$207K |
| E0147 |
Walker variable wheel resist |
1,078 |
1,063 |
$185K |
| E0630 |
Patient lift hydraulic |
2,604 |
2,547 |
$178K |
| K0806 |
Pov group 2 std up to 300lbs |
236 |
233 |
$154K |
| K0823 |
Pwc gp 2 std cap chair |
93 |
93 |
$149K |
| E0635 |
Patient lift electric |
1,096 |
1,076 |
$101K |
| K0195 |
Elevating whlchair leg rests |
4,969 |
4,903 |
$93K |
| E0272 |
Mattress foam rubber |
2,525 |
2,474 |
$93K |
| E0143 |
Walker folding wheeled w/o s |
1,270 |
1,239 |
$91K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,065 |
1,037 |
$87K |
| K0812 |
Power operated vehicle noc |
96 |
96 |
$83K |
| E0305 |
Rails bed side half length |
6,638 |
6,548 |
$80K |
| E0245 |
Tub stool or bench |
779 |
769 |
$42K |
| E0240 |
Bath/shower chair |
115 |
114 |
$37K |
| E0310 |
Rails bed side full length |
2,221 |
2,208 |
$31K |
| K0807 |
Pov group 2 hd 301-450 lbs |
29 |
29 |
$31K |
| E0156 |
Walker seat attachment |
2,130 |
2,093 |
$31K |
| E0163 |
Commode chair with fixed arm |
368 |
365 |
$29K |
| E1226 |
Manual fully reclining back |
414 |
407 |
$27K |
| E0971 |
Wheelchair anti-tipping devi |
886 |
860 |
$21K |
| E0271 |
Mattress innerspring |
720 |
710 |
$16K |
| K0002 |
Stnd hemi (low seat) whlchr |
201 |
198 |
$13K |
| E0973 |
W/ch access det adj armrest |
66 |
54 |
$12K |
| E0912 |
Hd trapeze bar free standing |
213 |
212 |
$11K |
| E1038 |
Transport chair pt wt<=300lb |
505 |
504 |
$11K |
| E2365 |
U1 sealed leadacid battery |
97 |
96 |
$10K |
| K0004 |
High strength ltwt whlchr |
128 |
121 |
$9K |
| K0040 |
Adjustable angle footplate |
30 |
26 |
$4K |
| E1039 |
Transport chair pt wt >300lb |
149 |
147 |
$3K |
| E0978 |
W/c acc,saf belt pelv strap |
176 |
172 |
$3K |
| E0247 |
Trans bench w/wo comm open |
28 |
28 |
$2K |
| E0149 |
Heavy duty wheeled walker |
18 |
18 |
$2K |
| E0910 |
Trapeze bar attached to bed |
90 |
90 |
$706.00 |
| E0105 |
Cane adjust/fixed quad/3 pro |
12 |
12 |
$149.24 |