| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
532 |
477 |
$333K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,851 |
798 |
$304K |
| K0005 |
Ultralightweight wheelchair |
53 |
52 |
$120K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
46 |
37 |
$71K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
831 |
525 |
$46K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
337 |
278 |
$32K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
379 |
320 |
$29K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
376 |
323 |
$27K |
| E2609 |
Custom fabricated wheelchair seat cushion, any size |
14 |
12 |
$7K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
71 |
69 |
$4K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
94 |
89 |
$3K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
19 |
14 |
$3K |
| K0040 |
Adjustable angle footplate, each |
160 |
132 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
196 |
163 |
$1K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
26 |
25 |
$246.38 |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
76 |
76 |
$0.00 |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
12 |
12 |
$0.00 |