| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
2,482 |
1,943 |
$237K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
2,849 |
1,327 |
$196K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
4,776 |
2,865 |
$152K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
3,605 |
2,761 |
$68K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
381 |
240 |
$19K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
416 |
281 |
$11K |
| E2392 |
Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each |
162 |
124 |
$10K |
| K0004 |
High strength, lightweight wheelchair |
332 |
254 |
$7K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
32 |
28 |
$3K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
18 |
12 |
$1K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
15 |
12 |
$1K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
16 |
14 |
$988.46 |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
15 |
12 |
$745.92 |