| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
2,768 |
1,529 |
$288K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
4,302 |
2,260 |
$173K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
569 |
566 |
$142K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
2,550 |
2,415 |
$114K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
24 |
24 |
$59K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
1,129 |
1,117 |
$36K |
| E1399 |
Durable medical equipment, miscellaneous |
42 |
13 |
$17K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
137 |
117 |
$10K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
38 |
38 |
$6K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
190 |
187 |
$4K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
55 |
52 |
$3K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
53 |
49 |
$3K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
26 |
25 |
$3K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
12 |
12 |
$3K |
| K0040 |
Adjustable angle footplate, each |
12 |
12 |
$732.00 |
| E1225 |
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each |
12 |
12 |
$437.03 |
| K0019 |
Arm pad, replacement only, each |
38 |
25 |
$303.39 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
14 |
12 |
$217.82 |