| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
985 |
675 |
$2.80M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
2,651 |
1,884 |
$1.97M |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
2,401 |
2,070 |
$105K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
149 |
103 |
$46K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
16 |
12 |
$2K |
| E0945 |
Extremity belt/harness |
14 |
12 |
$460.15 |