| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1007 |
Pwr seat combo w/shear |
177 |
175 |
$436K |
| K0001 |
Standard wheelchair |
37,912 |
37,792 |
$257K |
| E0295 |
Hosp bed semi-elect w/o matt |
16,625 |
16,585 |
$230K |
| K0108 |
W/c component-accessory nos |
477 |
404 |
$188K |
| E0143 |
Walker folding wheeled w/o s |
8,616 |
8,502 |
$182K |
| E2311 |
Electro connect btw 2 sys |
239 |
235 |
$165K |
| E2611 |
Gen use back cush wdth <22in |
2,714 |
2,688 |
$112K |
| E0973 |
W/ch access det adj armrest |
3,550 |
2,886 |
$85K |
| E0245 |
Tub stool or bench |
1,764 |
1,754 |
$83K |
| E0247 |
Trans bench w/wo comm open |
978 |
976 |
$72K |
| E1028 |
W/c manual swingaway |
1,315 |
880 |
$70K |
| K0823 |
Pwc gp 2 std cap chair |
207 |
206 |
$61K |
| K0003 |
Lightweight wheelchair |
2,437 |
2,429 |
$59K |
| E0240 |
Bath/shower chair |
88 |
85 |
$49K |
| E2363 |
Gr24 sealed leadacid battery |
373 |
368 |
$47K |
| E0971 |
Wheelchair anti-tipping devi |
3,704 |
3,079 |
$45K |
| K0739 |
Repair/svc dme non-oxygen eq |
784 |
721 |
$45K |
| E1161 |
Manual adult wc w tiltinspac |
515 |
513 |
$42K |
| E0630 |
Patient lift hydraulic |
2,675 |
2,663 |
$41K |
| K0195 |
Elevating whlchair leg rests |
7,465 |
7,414 |
$37K |
| E0305 |
Rails bed side half length |
16,340 |
16,287 |
$33K |
| E2377 |
Expandable controller, initl |
230 |
225 |
$33K |
| E0163 |
Commode chair with fixed arm |
1,893 |
1,869 |
$32K |
| E1012 |
Ctr mount pwr elev leg rest |
72 |
70 |
$30K |
| E0260 |
Hosp bed semi-electr w/ matt |
3,279 |
3,275 |
$30K |
| E2601 |
Gen w/c cushion wdth < 22 in |
2,618 |
2,595 |
$25K |
| E2313 |
Pwc harness, expand control |
254 |
246 |
$22K |
| E1038 |
Transport chair pt wt<=300lb |
4,585 |
4,577 |
$21K |
| E0635 |
Patient lift electric |
460 |
459 |
$18K |
| E0156 |
Walker seat attachment |
3,558 |
3,531 |
$17K |
| E0271 |
Mattress innerspring |
501 |
501 |
$17K |
| E0149 |
Heavy duty wheeled walker |
1,427 |
1,417 |
$12K |
| E1225 |
Manual semi-reclining back |
770 |
758 |
$11K |
| E0165 |
Commode chair with detacharm |
1,632 |
1,627 |
$11K |
| E0955 |
Cushioned headrest |
326 |
321 |
$9K |
| E0272 |
Mattress foam rubber |
209 |
208 |
$9K |
| E2366 |
Battery charger, single mode |
129 |
125 |
$8K |
| E2386 |
Foam filled drive wheel tire |
119 |
118 |
$7K |
| E0951 |
Loop heel |
1,469 |
1,455 |
$7K |
| K0007 |
Extra heavy duty wheelchair |
53 |
53 |
$4K |
| E0181 |
Press pad alternating w/ pum |
376 |
372 |
$3K |
| E2394 |
Drive wheel excludes tire |
90 |
90 |
$3K |
| E2365 |
U1 sealed leadacid battery |
27 |
25 |
$3K |
| E2387 |
Foam filled caster tire |
119 |
79 |
$3K |
| E0978 |
W/c acc,saf belt pelv strap |
210 |
204 |
$3K |
| E2620 |
Wc planar back cush wd <22in |
12 |
12 |
$2K |
| E0910 |
Trapeze bar attached to bed |
222 |
222 |
$1K |
| E0303 |
Hosp bed hvy dty xtra wide |
12 |
12 |
$912.04 |
| K0040 |
Adjustable angle footplate |
16 |
14 |
$894.32 |
| K0462 |
Temporary replacement eqpmnt |
12 |
12 |
$862.54 |
| E2395 |
Caster wheel excludes tire |
16 |
16 |
$587.44 |
| K0019 |
Arm pad repl, each |
72 |
71 |
$471.38 |
| K0006 |
Heavy duty wheelchair |
12 |
12 |
$166.52 |