| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1161 |
Manual adult wc w tiltinspac |
580 |
550 |
$1.46M |
| E2615 |
Pos back post/lat wdth <22in |
558 |
546 |
$242K |
| E2607 |
Skin pro/pos wc cus wd <22in |
810 |
792 |
$223K |
| E1028 |
W/c manual swingaway |
909 |
848 |
$221K |
| E0973 |
W/ch access det adj armrest |
1,022 |
976 |
$182K |
| E0955 |
Cushioned headrest |
773 |
740 |
$136K |
| K0108 |
W/c component-accessory nos |
702 |
399 |
$133K |
| K0005 |
Ultralightweight wheelchair |
47 |
47 |
$107K |
| E2231 |
Solid seat support base |
435 |
425 |
$73K |
| E0971 |
Wheelchair anti-tipping devi |
789 |
757 |
$73K |
| E2620 |
Wc planar back cush wd <22in |
131 |
129 |
$66K |
| E2203 |
Frame depth less than 22 in |
85 |
85 |
$45K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
80 |
79 |
$33K |
| K0739 |
Repair/svc dme non-oxygen eq |
315 |
305 |
$30K |
| K0004 |
High strength ltwt whlchr |
26 |
25 |
$12K |
| E0951 |
Loop heel |
175 |
171 |
$6K |
| E2608 |
Skin pro/pos wc cus wd>=22in |
13 |
13 |
$4K |
| K0040 |
Adjustable angle footplate |
19 |
14 |
$2K |
| E0961 |
Wheelchair brake extension |
26 |
26 |
$1K |