| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
4,296 |
1,891 |
$913K |
| K0739 |
Repair/svc dme non-oxygen eq |
4,123 |
3,811 |
$449K |
| K0823 |
Pwc gp 2 std cap chair |
156 |
154 |
$314K |
| E2361 |
22nf sealed leadacid battery |
1,198 |
1,102 |
$263K |
| E1028 |
W/c manual swingaway |
1,629 |
1,268 |
$236K |
| E0973 |
W/ch access det adj armrest |
936 |
922 |
$105K |
| K0004 |
High strength ltwt whlchr |
135 |
134 |
$98K |
| E0955 |
Cushioned headrest |
743 |
732 |
$75K |
| K0195 |
Elevating whlchair leg rests |
301 |
299 |
$53K |
| E2311 |
Electro connect btw 2 sys |
38 |
36 |
$51K |
| E2607 |
Skin pro/pos wc cus wd <22in |
169 |
166 |
$36K |
| E1007 |
Pwr seat combo w/shear |
12 |
12 |
$33K |
| E2611 |
Gen use back cush wdth <22in |
133 |
131 |
$23K |
| E2620 |
Wc planar back cush wd <22in |
68 |
67 |
$23K |
| E0971 |
Wheelchair anti-tipping devi |
280 |
277 |
$18K |
| K0040 |
Adjustable angle footplate |
192 |
172 |
$17K |
| E2377 |
Expandable controller, initl |
49 |
49 |
$16K |
| E2313 |
Pwc harness, expand control |
50 |
49 |
$11K |
| E0143 |
Walker folding wheeled w/o s |
150 |
150 |
$9K |
| E0978 |
W/c acc,saf belt pelv strap |
390 |
386 |
$9K |
| E0295 |
Hosp bed semi-elect w/o matt |
24 |
24 |
$6K |
| E2342 |
W/c dpth 20-21 in seat frame |
13 |
13 |
$4K |
| E0156 |
Walker seat attachment |
229 |
229 |
$4K |
| E1399 |
Durable medical equipment mi |
14 |
12 |
$3K |
| E2601 |
Gen w/c cushion wdth < 22 in |
71 |
70 |
$3K |
| K0056 |
Seat ht <17 or >=21 ltwt wc |
41 |
39 |
$2K |