| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
196 |
105 |
$94K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
266 |
218 |
$80K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
476 |
345 |
$5K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
23 |
12 |
$2K |