| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
348 |
216 |
$1.01M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
452 |
399 |
$123K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,093 |
830 |
$87K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,059 |
979 |
$38K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
183 |
163 |
$9K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
38 |
27 |
$8K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
12 |
12 |
$6K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
54 |
44 |
$3K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
29 |
25 |
$2K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
17 |
12 |
$712.98 |