| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
2,221 |
925 |
$269K |
| E1399 |
Durable medical equipment, miscellaneous |
412 |
117 |
$269K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,713 |
1,373 |
$43K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
935 |
397 |
$37K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
112 |
91 |
$5K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
16 |
14 |
$820.40 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
16 |
13 |
$653.72 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
16 |
12 |
$222.14 |