| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1161 |
Manual adult size wheelchair, includes tilt in space |
821 |
818 |
$64K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,286 |
1,231 |
$43K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
343 |
251 |
$30K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
351 |
343 |
$16K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
793 |
786 |
$13K |
| K0040 |
Adjustable angle footplate, each |
166 |
128 |
$6K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,097 |
874 |
$5K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
59 |
42 |
$1K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
46 |
28 |
$1K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
24 |
14 |
$302.03 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
23 |
13 |
$131.34 |