| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
201 |
172 |
$92K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
816 |
723 |
$22K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
28 |
25 |
$14K |
| K0040 |
Adjustable angle footplate, each |
14 |
14 |
$2K |
| E2395 |
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
13 |
12 |
$1K |
| E2210 |
Wheelchair accessory, bearings, any type, replacement only, each |
17 |
15 |
$468.53 |
| K0019 |
Arm pad, replacement only, each |
14 |
13 |
$369.68 |