| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
7,628 |
2,261 |
$1.02M |
| K0739 |
Repair/svc dme non-oxygen eq |
2,178 |
2,021 |
$140K |
| E0240 |
Bath/shower chair |
60 |
59 |
$72K |
| E1399 |
Durable medical equipment mi |
29 |
25 |
$37K |
| E0973 |
W/ch access det adj armrest |
257 |
209 |
$36K |
| K0040 |
Adjustable angle footplate |
302 |
265 |
$35K |
| E1028 |
W/c manual swingaway |
208 |
145 |
$33K |
| E0956 |
W/c lateral trunk/hip suppor |
122 |
91 |
$21K |
| E0960 |
W/c shoulder harness/straps |
275 |
229 |
$21K |
| E0978 |
W/c acc,saf belt pelv strap |
419 |
351 |
$12K |
| E0971 |
Wheelchair anti-tipping devi |
149 |
135 |
$11K |
| E0955 |
Cushioned headrest |
92 |
92 |
$11K |
| E2613 |
Position back cush wd <22in |
12 |
12 |
$4K |
| E2213 |
Pneumatic prop tire insert |
43 |
43 |
$2K |