| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1007 |
Pwr seat combo w/shear |
180 |
178 |
$374K |
| E0295 |
Hosp bed semi-elect w/o matt |
6,022 |
5,995 |
$138K |
| E2311 |
Electro connect btw 2 sys |
208 |
206 |
$109K |
| K0823 |
Pwc gp 2 std cap chair |
923 |
923 |
$69K |
| K0001 |
Standard wheelchair |
6,068 |
6,044 |
$61K |
| E0973 |
W/ch access det adj armrest |
1,734 |
1,146 |
$47K |
| E2611 |
Gen use back cush wdth <22in |
937 |
925 |
$45K |
| E0185 |
Gel pressure mattress pad |
642 |
639 |
$37K |
| E1161 |
Manual adult wc w tiltinspac |
485 |
481 |
$30K |
| E0630 |
Patient lift hydraulic |
1,252 |
1,250 |
$28K |
| E0310 |
Rails bed side full length |
732 |
727 |
$25K |
| E0272 |
Mattress foam rubber |
722 |
717 |
$25K |
| E0143 |
Walker folding wheeled w/o s |
1,225 |
1,192 |
$23K |
| E2377 |
Expandable controller, initl |
200 |
197 |
$23K |
| E1012 |
Ctr mount pwr elev leg rest |
148 |
146 |
$23K |
| E0971 |
Wheelchair anti-tipping devi |
1,653 |
1,111 |
$21K |
| E1028 |
W/c manual swingaway |
612 |
351 |
$18K |
| E0163 |
Commode chair with fixed arm |
885 |
867 |
$18K |
| E2313 |
Pwc harness, expand control |
219 |
215 |
$11K |
| E2359 |
Gr34 sealed leadacid battery |
124 |
122 |
$11K |
| E1038 |
Transport chair pt wt<=300lb |
2,034 |
2,032 |
$10K |
| E2601 |
Gen w/c cushion wdth < 22 in |
875 |
865 |
$10K |
| K0005 |
Ultralightweight wheelchair |
14 |
13 |
$9K |
| E0951 |
Loop heel |
1,108 |
1,094 |
$9K |
| E0181 |
Press pad alternating w/ pum |
1,086 |
1,074 |
$8K |
| K0040 |
Adjustable angle footplate |
504 |
259 |
$7K |
| K0195 |
Elevating whlchair leg rests |
1,376 |
1,352 |
$6K |
| E0955 |
Cushioned headrest |
229 |
227 |
$6K |
| E0245 |
Tub stool or bench |
96 |
95 |
$5K |
| E1225 |
Manual semi-reclining back |
482 |
466 |
$5K |
| K0821 |
Pwc gp 2 std port cap chair |
53 |
53 |
$4K |
| E0156 |
Walker seat attachment |
597 |
590 |
$3K |
| K0006 |
Heavy duty wheelchair |
38 |
38 |
$3K |
| E2620 |
Wc planar back cush wd <22in |
14 |
14 |
$2K |
| E2607 |
Skin pro/pos wc cus wd <22in |
33 |
32 |
$2K |
| E0165 |
Commode chair with detacharm |
284 |
284 |
$1K |
| E0247 |
Trans bench w/wo comm open |
15 |
15 |
$1K |
| E0305 |
Rails bed side half length |
259 |
259 |
$1K |
| E2219 |
Foam caster tire any size ea |
59 |
57 |
$1K |
| E2218 |
Foam propulsion tire each |
13 |
12 |
$407.50 |
| E0961 |
Wheelchair brake extension |
44 |
42 |
$339.67 |
| K0739 |
Repair/svc dme non-oxygen eq |
14 |
13 |
$327.52 |
| E0978 |
W/c acc,saf belt pelv strap |
43 |
42 |
$260.37 |
| E0910 |
Trapeze bar attached to bed |
12 |
12 |
$32.88 |