| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Pwc gp 2 std cap chair |
3,186 |
3,164 |
$210K |
| E1002 |
Pwr seat tilt |
64 |
64 |
$168K |
| E1390 |
Oxygen concentrator |
3,718 |
3,678 |
$133K |
| K0825 |
Pwc gp 2 hd cap chair |
1,459 |
1,439 |
$126K |
| E0260 |
Hosp bed semi-electr w/ matt |
6,104 |
6,075 |
$123K |
| K0816 |
Pwc gp 1 std cap chair |
2,926 |
2,862 |
$119K |
| E2361 |
22nf sealed leadacid battery |
1,495 |
1,344 |
$105K |
| K0003 |
Lightweight wheelchair |
4,771 |
4,723 |
$71K |
| E0955 |
Cushioned headrest |
1,639 |
1,604 |
$66K |
| K0002 |
Stnd hemi (low seat) whlchr |
5,707 |
5,680 |
$63K |
| E1007 |
Pwr seat combo w/shear |
42 |
37 |
$40K |
| E1028 |
W/c manual swingaway |
2,204 |
1,227 |
$38K |
| E0630 |
Patient lift hydraulic |
1,943 |
1,940 |
$37K |
| K0195 |
Elevating whlchair leg rests |
12,095 |
12,022 |
$31K |
| E2611 |
Gen use back cush wdth <22in |
820 |
791 |
$29K |
| E2365 |
U1 sealed leadacid battery |
824 |
716 |
$29K |
| K0738 |
Portable gas oxygen system |
2,963 |
2,925 |
$23K |
| E2311 |
Electro connect btw 2 sys |
131 |
124 |
$19K |
| K0739 |
Repair/svc dme non-oxygen eq |
2,427 |
2,214 |
$18K |
| E0277 |
Powered pres-redu air mattrs |
423 |
420 |
$17K |
| K0006 |
Heavy duty wheelchair |
682 |
675 |
$15K |
| E1012 |
Ctr mount pwr elev leg rest |
52 |
50 |
$14K |
| E0294 |
Hosp bed semi-elect w/ mattr |
426 |
426 |
$13K |
| E0971 |
Wheelchair anti-tipping devi |
1,601 |
945 |
$13K |
| K0007 |
Extra heavy duty wheelchair |
420 |
419 |
$12K |
| E0973 |
W/ch access det adj armrest |
864 |
475 |
$11K |
| K0108 |
W/c component-accessory nos |
255 |
177 |
$11K |
| E0185 |
Gel pressure mattress pad |
207 |
206 |
$10K |
| E0961 |
Wheelchair brake extension |
1,300 |
694 |
$8K |
| E2310 |
Electro connect btw control |
13 |
13 |
$8K |
| E2601 |
Gen w/c cushion wdth < 22 in |
711 |
685 |
$6K |
| E2313 |
Pwc harness, expand control |
78 |
73 |
$5K |
| E0261 |
Hosp bed semi-electr w/o mat |
245 |
245 |
$5K |
| E0978 |
W/c acc,saf belt pelv strap |
739 |
714 |
$4K |
| E0143 |
Walker folding wheeled w/o s |
104 |
103 |
$3K |
| E2620 |
Wc planar back cush wd <22in |
38 |
37 |
$3K |
| E0303 |
Hosp bed hvy dty xtra wide |
88 |
88 |
$3K |
| E2377 |
Expandable controller, initl |
77 |
73 |
$3K |
| K0001 |
Standard wheelchair |
348 |
348 |
$2K |
| K0004 |
High strength ltwt whlchr |
109 |
107 |
$2K |
| E2607 |
Skin pro/pos wc cus wd <22in |
12 |
12 |
$904.24 |
| E0181 |
Press pad alternating w/ pum |
230 |
230 |
$820.32 |
| K0040 |
Adjustable angle footplate |
18 |
12 |
$341.99 |
| E0910 |
Trapeze bar attached to bed |
63 |
61 |
$147.10 |
| E0156 |
Walker seat attachment |
19 |
19 |
$123.00 |