| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,997 |
707 |
$46K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
807 |
509 |
$12K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
219 |
161 |
$9K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
137 |
91 |
$956.74 |
| K0001 |
Standard wheelchair |
46 |
42 |
$394.98 |