| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0861 |
Pwc gp3 std mult pow opt s/b |
96 |
93 |
$366K |
| K0108 |
W/c component-accessory nos |
400 |
139 |
$191K |
| K0001 |
Standard wheelchair |
5,335 |
5,273 |
$147K |
| E0295 |
Hosp bed semi-elect w/o matt |
1,798 |
1,775 |
$106K |
| K0003 |
Lightweight wheelchair |
1,876 |
1,835 |
$74K |
| E0973 |
W/ch access det adj armrest |
1,746 |
1,692 |
$65K |
| E0247 |
Trans bench w/wo comm open |
918 |
901 |
$53K |
| E0143 |
Walker folding wheeled w/o s |
1,074 |
1,057 |
$48K |
| E0971 |
Wheelchair anti-tipping devi |
4,900 |
4,533 |
$41K |
| E1028 |
W/c manual swingaway |
181 |
76 |
$30K |
| K0195 |
Elevating whlchair leg rests |
2,020 |
1,990 |
$27K |
| E0305 |
Rails bed side half length |
1,293 |
1,275 |
$19K |
| E0163 |
Commode chair with fixed arm |
349 |
343 |
$17K |
| E0978 |
W/c acc,saf belt pelv strap |
3,335 |
3,263 |
$15K |
| K0739 |
Repair/svc dme non-oxygen eq |
332 |
316 |
$14K |
| E0271 |
Mattress innerspring |
592 |
589 |
$10K |
| K0040 |
Adjustable angle footplate |
125 |
112 |
$10K |
| E0630 |
Patient lift hydraulic |
61 |
61 |
$3K |
| E0165 |
Commode chair with detacharm |
48 |
48 |
$3K |
| E2607 |
Skin pro/pos wc cus wd <22in |
14 |
12 |
$3K |
| E0955 |
Cushioned headrest |
37 |
37 |
$2K |
| E0310 |
Rails bed side full length |
102 |
102 |
$2K |
| K0006 |
Heavy duty wheelchair |
25 |
25 |
$2K |
| E0245 |
Tub stool or bench |
38 |
38 |
$2K |
| E0156 |
Walker seat attachment |
119 |
118 |
$1K |
| E0961 |
Wheelchair brake extension |
116 |
108 |
$886.66 |
| E2209 |
Arm trough each |
68 |
66 |
$631.28 |
| E0240 |
Bath/shower chair |
14 |
13 |
$291.06 |