| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
348 |
120 |
$51K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
58 |
26 |
$8K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
117 |
108 |
$6K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
19 |
12 |
$2K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
12 |
12 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
12 |
12 |
$937.20 |