| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1150 |
Wheelchair, detachable arms, desk or full length swing away detachable elevating legrests |
540 |
443 |
$30K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,027 |
1,457 |
$20K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
27 |
12 |
$2K |
| K0001 |
Standard wheelchair |
138 |
133 |
$1K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
65 |
62 |
$876.10 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
42 |
37 |
$146.32 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
24 |
12 |
$93.85 |