| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
637 |
623 |
$475K |
| T4541 |
Incontinence product, disposable underpad, large, each |
1,751 |
1,720 |
$89K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
441 |
434 |
$50K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
148 |
104 |
$23K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
300 |
273 |
$19K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
225 |
151 |
$17K |
| K0040 |
Adjustable angle footplate, each |
117 |
88 |
$14K |
| A6250 |
Skin sealants, protectants, moisturizers, ointments, any type, any size |
941 |
914 |
$13K |
| A4335 |
Incontinence supply; miscellaneous |
950 |
936 |
$10K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
124 |
123 |
$7K |
| T4523 |
Adult sized disposable incontinence product, brief/diaper, large, each |
56 |
49 |
$7K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
53 |
39 |
$4K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
64 |
51 |
$2K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
12 |
12 |
$732.60 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
13 |
13 |
$564.20 |