| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
401 |
324 |
$1.15M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
953 |
692 |
$258K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
583 |
571 |
$178K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
485 |
396 |
$39K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,698 |
1,556 |
$25K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
249 |
241 |
$25K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
375 |
304 |
$16K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
219 |
207 |
$9K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
17 |
14 |
$8K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
12 |
12 |
$8K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
66 |
66 |
$3K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
27 |
27 |
$1K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
14 |
14 |
$1K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
31 |
26 |
$758.35 |
| K0040 |
Adjustable angle footplate, each |
20 |
14 |
$404.38 |