| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
243 |
205 |
$65K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
815 |
644 |
$50K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
874 |
791 |
$20K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
166 |
156 |
$7K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
30 |
26 |
$2K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
12 |
12 |
$1K |