| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,153 |
558 |
$126K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,716 |
1,429 |
$56K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
656 |
397 |
$43K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
333 |
299 |
$15K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
26 |
24 |
$10K |