| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,151 |
447 |
$139K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,219 |
635 |
$51K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
252 |
239 |
$41K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
538 |
528 |
$37K |
| K0001 |
Standard wheelchair |
984 |
962 |
$30K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
708 |
620 |
$22K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
38 |
25 |
$21K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
316 |
301 |
$11K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
255 |
248 |
$4K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
15 |
13 |
$2K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
13 |
12 |
$2K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
22 |
15 |
$1K |