| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,194 |
762 |
$114K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
280 |
171 |
$47K |
| K0005 |
Ultralightweight wheelchair |
14 |
13 |
$11K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
28 |
24 |
$9K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
194 |
165 |
$3K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
16 |
12 |
$1K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
15 |
12 |
$777.69 |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
13 |
12 |
$319.06 |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
13 |
12 |
$206.31 |