| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,713 |
554 |
$77K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
820 |
575 |
$54K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
2,311 |
1,252 |
$35K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,817 |
1,322 |
$21K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
1,065 |
742 |
$10K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
62 |
38 |
$2K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
18 |
13 |
$964.46 |