| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,415 |
1,357 |
$121K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,759 |
1,324 |
$103K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
767 |
451 |
$101K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
546 |
540 |
$80K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
94 |
93 |
$18K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
157 |
127 |
$13K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
208 |
199 |
$11K |
| K0040 |
Adjustable angle footplate, each |
29 |
24 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
75 |
65 |
$2K |
| E2392 |
Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each |
26 |
25 |
$1K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
13 |
12 |
$968.07 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
14 |
12 |
$681.42 |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
12 |
12 |
$583.76 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
14 |
12 |
$16.06 |