| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
435 |
280 |
$942K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
2,637 |
1,079 |
$430K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
3,697 |
1,264 |
$282K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
296 |
164 |
$128K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,248 |
782 |
$33K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
174 |
114 |
$19K |
| K0040 |
Adjustable angle footplate, each |
175 |
109 |
$12K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
328 |
257 |
$8K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
163 |
103 |
$6K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
77 |
68 |
$5K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
17 |
14 |
$3K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
69 |
42 |
$2K |