| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
3,487 |
2,898 |
$718K |
| K0739 |
Repair/svc dme non-oxygen eq |
4,582 |
4,360 |
$268K |
| E1028 |
W/c manual swingaway |
2,540 |
1,996 |
$174K |
| K0823 |
Pwc gp 2 std cap chair |
993 |
986 |
$143K |
| E0973 |
W/ch access det adj armrest |
593 |
497 |
$44K |
| E1161 |
Manual adult wc w tiltinspac |
232 |
230 |
$42K |
| K0821 |
Pwc gp 2 std port cap chair |
198 |
197 |
$36K |
| E0955 |
Cushioned headrest |
547 |
542 |
$21K |
| E1399 |
Durable medical equipment mi |
15 |
13 |
$20K |
| E0240 |
Bath/shower chair |
13 |
13 |
$12K |
| K0040 |
Adjustable angle footplate |
93 |
75 |
$9K |
| E0978 |
W/c acc,saf belt pelv strap |
252 |
229 |
$5K |
| E0956 |
W/c lateral trunk/hip suppor |
30 |
28 |
$4K |
| E2607 |
Skin pro/pos wc cus wd <22in |
20 |
12 |
$4K |
| E2392 |
Solid caster tire, integrate |
38 |
37 |
$4K |
| E0971 |
Wheelchair anti-tipping devi |
66 |
65 |
$3K |
| E0960 |
W/c shoulder harness/straps |
31 |
31 |
$2K |
| E2361 |
22nf sealed leadacid battery |
26 |
25 |
$2K |
| E2213 |
Pneumatic prop tire insert |
26 |
24 |
$735.78 |
| E2206 |
Man wc whl lock comp repl ea |
13 |
12 |
$162.50 |