| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
10,333 |
2,299 |
$12.65M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
3,786 |
700 |
$878K |
| E0641 |
Standing frame/table system, multi-position (e.g., three-way stander), any size including pediatric, with or without wheels |
41 |
39 |
$228K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
103 |
100 |
$129K |
| E2609 |
Custom fabricated wheelchair seat cushion, any size |
75 |
60 |
$92K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
604 |
192 |
$79K |
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
55 |
46 |
$73K |
| T5001 |
Positioning seat for persons with special orthopedic needs |
73 |
62 |
$62K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
313 |
250 |
$47K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
446 |
357 |
$28K |
| E8000 |
Gait trainer, pediatric size, posterior support, includes all accessories and components |
13 |
12 |
$25K |
| K0040 |
Adjustable angle footplate, each |
323 |
229 |
$20K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
247 |
87 |
$17K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
393 |
343 |
$9K |
| E0950 |
Wheelchair accessory, tray, each |
105 |
72 |
$7K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
215 |
185 |
$7K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
16 |
13 |
$6K |
| T5999 |
Supply, not otherwise specified |
204 |
200 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
29 |
12 |
$953.16 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
39 |
25 |
$639.30 |
| E0952 |
Toe loop/holder, any type, each |
13 |
12 |
$421.20 |
| A4554 |
Disposable underpads, all sizes |
12 |
12 |
$397.28 |