| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,331 |
671 |
$489K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
427 |
274 |
$76K |
| E1399 |
Durable medical equipment, miscellaneous |
15 |
15 |
$58K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
676 |
515 |
$50K |
| K0040 |
Adjustable angle footplate, each |
92 |
61 |
$8K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
116 |
64 |
$7K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
98 |
82 |
$3K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
18 |
12 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
49 |
38 |
$2K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
15 |
12 |
$2K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
13 |
13 |
$794.16 |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
12 |
12 |
$587.88 |