| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
349 |
307 |
$120K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
120 |
106 |
$52K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
992 |
881 |
$25K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
114 |
107 |
$15K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
86 |
76 |
$12K |
| K0040 |
Adjustable angle footplate, each |
109 |
94 |
$11K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
102 |
87 |
$5K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
29 |
24 |
$4K |
| Z0160 |
|
31 |
25 |
$4K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
103 |
96 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
44 |
43 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
14 |
12 |
$288.40 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
12 |
12 |
$255.78 |