| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
276 |
65 |
$108K |
| E1399 |
Durable medical equipment mi |
102 |
88 |
$97K |
| K0004 |
High strength ltwt whlchr |
2,510 |
2,442 |
$94K |
| E0147 |
Walker variable wheel resist |
622 |
613 |
$84K |
| K0739 |
Repair/svc dme non-oxygen eq |
437 |
375 |
$35K |
| E0240 |
Bath/shower chair |
299 |
295 |
$33K |
| E0295 |
Hosp bed semi-elect w/o matt |
579 |
574 |
$23K |
| K0001 |
Standard wheelchair |
467 |
460 |
$16K |
| K0040 |
Adjustable angle footplate |
1,999 |
1,917 |
$12K |
| E2363 |
Gr24 sealed leadacid battery |
84 |
82 |
$11K |
| K0806 |
Pov group 2 std up to 300lbs |
16 |
16 |
$9K |
| K0823 |
Pwc gp 2 std cap chair |
15 |
15 |
$8K |
| E1031 |
Rollabout chair with casters |
399 |
395 |
$7K |
| E0310 |
Rails bed side full length |
505 |
482 |
$6K |
| E0156 |
Walker seat attachment |
834 |
823 |
$6K |
| K0195 |
Elevating whlchair leg rests |
537 |
522 |
$4K |
| E2366 |
Battery charger, single mode |
42 |
42 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
131 |
130 |
$2K |
| E0271 |
Mattress innerspring |
25 |
25 |
$306.00 |