| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
4,062 |
1,724 |
$311K |
| E1028 |
W/c manual swingaway |
5,189 |
3,174 |
$155K |
| K0739 |
Repair/svc dme non-oxygen eq |
3,593 |
3,017 |
$123K |
| K0823 |
Pwc gp 2 std cap chair |
960 |
910 |
$93K |
| K0825 |
Pwc gp 2 hd cap chair |
258 |
234 |
$49K |
| E0955 |
Cushioned headrest |
1,217 |
1,102 |
$36K |
| E1161 |
Manual adult wc w tiltinspac |
309 |
294 |
$31K |
| E0973 |
W/ch access det adj armrest |
604 |
398 |
$27K |
| E2361 |
22nf sealed leadacid battery |
80 |
62 |
$4K |
| E0956 |
W/c lateral trunk/hip suppor |
66 |
39 |
$3K |
| E0978 |
W/c acc,saf belt pelv strap |
158 |
141 |
$2K |
| E2392 |
Solid caster tire, integrate |
35 |
24 |
$2K |
| K0040 |
Adjustable angle footplate |
36 |
24 |
$977.25 |
| A4351 |
Straight tip urine catheter |
15 |
13 |
$875.40 |
| E2365 |
U1 sealed leadacid battery |
15 |
12 |
$392.59 |