| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
237 |
218 |
$447K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
2,311 |
2,295 |
$401K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
618 |
470 |
$165K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
2,611 |
2,596 |
$73K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
2,654 |
2,350 |
$51K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,608 |
1,528 |
$44K |
| K0040 |
Adjustable angle footplate, each |
393 |
339 |
$23K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
515 |
383 |
$15K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
132 |
129 |
$6K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
82 |
81 |
$3K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
53 |
38 |
$2K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
12 |
12 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
136 |
104 |
$2K |
| K0003 |
Lightweight wheelchair |
36 |
36 |
$1K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
12 |
12 |
$1K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
160 |
158 |
$1K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$405.92 |
| K0001 |
Standard wheelchair |
24 |
24 |
$48.51 |