| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
W/c component-accessory nos |
3,492 |
1,658 |
$1.92M |
| K0005 |
Ultralightweight wheelchair |
933 |
619 |
$993K |
| E1161 |
Manual adult wc w tiltinspac |
925 |
616 |
$805K |
| E2510 |
Sgd w multi methods msg/accs |
78 |
66 |
$405K |
| E2607 |
Skin pro/pos wc cus wd <22in |
1,391 |
842 |
$157K |
| E0973 |
W/ch access det adj armrest |
2,569 |
1,412 |
$134K |
| E0261 |
Hosp bed semi-electr w/o mat |
4,931 |
4,171 |
$123K |
| E1028 |
W/c manual swingaway |
4,832 |
3,007 |
$118K |
| E2613 |
Position back cush wd <22in |
630 |
372 |
$111K |
| K0823 |
Pwc gp 2 std cap chair |
1,661 |
1,430 |
$111K |
| K0821 |
Pwc gp 2 std port cap chair |
1,230 |
1,042 |
$99K |
| E0570 |
Nebulizer with compression |
4,556 |
3,829 |
$85K |
| E1390 |
Oxygen concentrator |
2,331 |
1,729 |
$79K |
| E0971 |
Wheelchair anti-tipping devi |
2,082 |
1,234 |
$71K |
| E2203 |
Frame depth less than 22 in |
221 |
162 |
$67K |
| K0040 |
Adjustable angle footplate |
1,218 |
676 |
$64K |
| E2201 |
Man w/ch acc seat w>=20"<24" |
251 |
172 |
$53K |
| E0955 |
Cushioned headrest |
1,163 |
767 |
$46K |
| E2620 |
Wc planar back cush wd <22in |
277 |
162 |
$46K |
| K0861 |
Pwc gp3 std mult pow opt s/b |
20 |
12 |
$41K |
| E0990 |
Wheelchair elevating leg res |
436 |
249 |
$35K |
| E2211 |
Pneumatic propulsion tire |
959 |
585 |
$34K |
| E0630 |
Patient lift hydraulic |
1,399 |
1,218 |
$32K |
| E1399 |
Durable medical equipment mi |
15 |
14 |
$32K |
| E0961 |
Wheelchair brake extension |
1,433 |
836 |
$32K |
| E0143 |
Walker folding wheeled w/o s |
1,286 |
1,124 |
$30K |
| E2213 |
Pneumatic prop tire insert |
637 |
438 |
$23K |
| K0002 |
Stnd hemi (low seat) whlchr |
1,214 |
989 |
$22K |
| E1007 |
Pwr seat combo w/shear |
42 |
24 |
$19K |
| E0431 |
Portable gaseous 02 |
1,642 |
1,265 |
$19K |
| K0825 |
Pwc gp 2 hd cap chair |
42 |
36 |
$15K |
| E0260 |
Hosp bed semi-electr w/ matt |
459 |
418 |
$12K |
| E2300 |
Pwr seat elevation sys |
15 |
12 |
$10K |
| A7005 |
Nondisposable nebulizer set |
967 |
805 |
$9K |
| E1225 |
Manual semi-reclining back |
33 |
24 |
$9K |
| E1012 |
Ctr mount pwr elev leg rest |
27 |
18 |
$9K |
| K0739 |
Repair/svc dme non-oxygen eq |
501 |
389 |
$8K |
| E2611 |
Gen use back cush wdth <22in |
103 |
81 |
$7K |
| E2359 |
Gr34 sealed leadacid battery |
22 |
13 |
$7K |
| E0954 |
Foot box, any type each foot |
150 |
83 |
$7K |
| E0149 |
Heavy duty wheeled walker |
981 |
887 |
$7K |
| E0951 |
Loop heel |
587 |
286 |
$6K |
| E2231 |
Solid seat support base |
62 |
46 |
$6K |
| E0163 |
Commode chair with fixed arm |
218 |
197 |
$5K |
| E2311 |
Electro connect btw 2 sys |
41 |
24 |
$5K |
| E0156 |
Walker seat attachment |
1,061 |
935 |
$5K |
| E2615 |
Pos back post/lat wdth <22in |
17 |
12 |
$5K |
| A5500 |
Diab shoe for density insert |
65 |
53 |
$4K |
| E0978 |
W/c acc,saf belt pelv strap |
352 |
207 |
$4K |
| E0165 |
Commode chair with detacharm |
536 |
486 |
$3K |
| E0956 |
W/c lateral trunk/hip suppor |
53 |
29 |
$3K |
| K0001 |
Standard wheelchair |
172 |
166 |
$2K |
| E0184 |
Dry pressure mattress |
55 |
49 |
$975.27 |
| A7015 |
Aerosol mask used w nebulize |
982 |
825 |
$867.20 |
| K0020 |
Fixed adjust armrest pair |
36 |
19 |
$754.00 |
| E0910 |
Trapeze bar attached to bed |
144 |
117 |
$475.66 |
| E0601 |
Cont airway pressure device |
15 |
12 |
$201.21 |
| K0195 |
Elevating whlchair leg rests |
131 |
94 |
$189.58 |
| A5512 |
Multi den insert direct form |
65 |
53 |
$35.03 |
| E2313 |
Pwc harness, expand control |
21 |
12 |
$0.00 |
| E2377 |
Expandable controller, initl |
20 |
12 |
$0.00 |