| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
3,831 |
3,408 |
$1.66M |
| E1399 |
Durable medical equipment mi |
758 |
692 |
$1.37M |
| E0240 |
Bath/shower chair |
556 |
546 |
$986K |
| E1028 |
W/c manual swingaway |
1,885 |
1,639 |
$362K |
| K0739 |
Repair/svc dme non-oxygen eq |
3,263 |
3,086 |
$262K |
| E0973 |
W/ch access det adj armrest |
905 |
797 |
$130K |
| E0956 |
W/c lateral trunk/hip suppor |
459 |
396 |
$96K |
| E0960 |
W/c shoulder harness/straps |
954 |
796 |
$75K |
| E0971 |
Wheelchair anti-tipping devi |
889 |
807 |
$68K |
| E2613 |
Position back cush wd <22in |
141 |
105 |
$48K |
| K0040 |
Adjustable angle footplate |
441 |
403 |
$43K |
| E0955 |
Cushioned headrest |
395 |
374 |
$41K |
| K0005 |
Ultralightweight wheelchair |
24 |
24 |
$39K |
| E2607 |
Skin pro/pos wc cus wd <22in |
141 |
141 |
$35K |
| E0950 |
Tray |
270 |
235 |
$22K |
| E2213 |
Pneumatic prop tire insert |
456 |
432 |
$20K |
| E2219 |
Foam caster tire any size ea |
69 |
54 |
$4K |
| E2203 |
Frame depth less than 22 in |
12 |
12 |
$4K |
| E0978 |
W/c acc,saf belt pelv strap |
92 |
92 |
$3K |
| K0038 |
Leg strap each |
64 |
52 |
$1K |
| E0951 |
Loop heel |
44 |
41 |
$1K |
| E2231 |
Solid seat support base |
12 |
12 |
$818.70 |
| E2211 |
Pneumatic propulsion tire |
14 |
14 |
$514.70 |