| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment mi |
964 |
501 |
$790K |
| K0108 |
W/c component-accessory nos |
4,951 |
2,051 |
$343K |
| K0739 |
Repair/svc dme non-oxygen eq |
2,164 |
1,998 |
$130K |
| E1028 |
W/c manual swingaway |
1,435 |
946 |
$121K |
| E0955 |
Cushioned headrest |
481 |
460 |
$44K |
| K0040 |
Adjustable angle footplate |
268 |
219 |
$13K |
| E2361 |
22nf sealed leadacid battery |
99 |
90 |
$11K |
| E0978 |
W/c acc,saf belt pelv strap |
376 |
368 |
$8K |
| E1161 |
Manual adult wc w tiltinspac |
28 |
27 |
$8K |
| E0960 |
W/c shoulder harness/straps |
134 |
126 |
$7K |
| E0971 |
Wheelchair anti-tipping devi |
168 |
134 |
$7K |
| E0956 |
W/c lateral trunk/hip suppor |
62 |
43 |
$7K |
| E0973 |
W/ch access det adj armrest |
101 |
82 |
$6K |
| E2607 |
Skin pro/pos wc cus wd <22in |
28 |
27 |
$4K |
| E2311 |
Electro connect btw 2 sys |
16 |
12 |
$3K |