| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
911 |
702 |
$312K |
| K0001 |
Standard wheelchair |
595 |
593 |
$19K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
188 |
186 |
$13K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
283 |
231 |
$7K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
43 |
38 |
$6K |