| 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 |
2,169 |
1,477 |
$57K |
| E2370 |
Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only |
23 |
12 |
$2K |
| K0462 |
Temporary replacement for patient owned equipment being repaired, any type |
25 |
24 |
$1K |
| E2395 |
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
87 |
25 |
$1K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
13 |
12 |
$967.46 |
| E2387 |
Power wheelchair accessory, foam filled caster tire, any size, replacement only, each |
39 |
12 |
$957.18 |
| K0001 |
Standard wheelchair |
68 |
68 |
$466.51 |
| K0003 |
Lightweight wheelchair |
54 |
54 |
$359.81 |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
12 |
12 |
$338.39 |
| K0002 |
Standard hemi (low seat) wheelchair |
40 |
40 |
$314.97 |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
24 |
12 |
$284.86 |
| E0156 |
Seat attachment, walker |
24 |
24 |
$87.24 |