| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
373 |
261 |
$63K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
46 |
26 |
$20K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
58 |
50 |
$4K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
13 |
12 |
$4K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
14 |
14 |
$2K |
| E2363 |
Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
13 |
13 |
$2K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
13 |
13 |
$1K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
12 |
12 |
$1K |