| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
890 |
881 |
$81K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
107 |
107 |
$14K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
401 |
275 |
$7K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
25 |
25 |
$4K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
212 |
211 |
$3K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
46 |
44 |
$547.40 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
48 |
24 |
$427.92 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
36 |
36 |
$112.27 |