| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
8,930 |
3,150 |
$2.05M |
| E0240 |
Bath/shower chair |
194 |
191 |
$406K |
| E1399 |
Durable medical equipment mi |
168 |
136 |
$306K |
| K0739 |
Repair/svc dme non-oxygen eq |
2,391 |
2,295 |
$193K |
| E1028 |
W/c manual swingaway |
718 |
542 |
$172K |
| E2617 |
Custom fab w/c back cushion |
124 |
124 |
$138K |
| K0040 |
Adjustable angle footplate |
719 |
526 |
$82K |
| E0973 |
W/ch access det adj armrest |
586 |
477 |
$81K |
| E2609 |
Custom fabricate w/c cushion |
86 |
85 |
$76K |
| E0956 |
W/c lateral trunk/hip suppor |
274 |
160 |
$60K |
| E0960 |
W/c shoulder harness/straps |
436 |
285 |
$34K |
| E0971 |
Wheelchair anti-tipping devi |
396 |
295 |
$29K |
| E0955 |
Cushioned headrest |
136 |
127 |
$17K |
| E2213 |
Pneumatic prop tire insert |
122 |
122 |
$7K |
| E0978 |
W/c acc,saf belt pelv strap |
226 |
215 |
$6K |
| E2219 |
Foam caster tire any size ea |
14 |
13 |
$908.08 |
| E0951 |
Loop heel |
22 |
13 |
$647.29 |