| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
10,550 |
4,613 |
$2.34M |
| K0739 |
Repair/svc dme non-oxygen eq |
6,518 |
6,102 |
$528K |
| E0240 |
Bath/shower chair |
344 |
323 |
$521K |
| E1028 |
W/c manual swingaway |
1,598 |
1,263 |
$279K |
| E1399 |
Durable medical equipment mi |
281 |
243 |
$169K |
| K0040 |
Adjustable angle footplate |
873 |
722 |
$100K |
| E0973 |
W/ch access det adj armrest |
649 |
556 |
$93K |
| E8000 |
Posterior gait trainer |
39 |
39 |
$86K |
| E0960 |
W/c shoulder harness/straps |
655 |
547 |
$51K |
| E2617 |
Custom fab w/c back cushion |
44 |
38 |
$47K |
| E0971 |
Wheelchair anti-tipping devi |
372 |
302 |
$29K |
| E0956 |
W/c lateral trunk/hip suppor |
140 |
107 |
$29K |
| E0978 |
W/c acc,saf belt pelv strap |
902 |
834 |
$26K |
| K0005 |
Ultralightweight wheelchair |
12 |
12 |
$18K |
| E0955 |
Cushioned headrest |
148 |
137 |
$17K |
| E2386 |
Foam filled drive wheel tire |
49 |
44 |
$11K |
| E2394 |
Drive wheel excludes tire |
75 |
67 |
$9K |
| E2607 |
Skin pro/pos wc cus wd <22in |
37 |
37 |
$9K |
| E2219 |
Foam caster tire any size ea |
106 |
90 |
$7K |
| E2392 |
Solid caster tire, integrate |
26 |
24 |
$3K |
| E2624 |
Adj skin pro/pos cus<22in |
13 |
12 |
$3K |
| E0950 |
Tray |
19 |
12 |
$1K |
| K0019 |
Arm pad repl, each |
12 |
12 |
$351.74 |