| Code | Description | Claims | Bene. Records | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
238 |
154 |
$450K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
255 |
165 |
$51K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
205 |
158 |
$14K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
431 |
257 |
$12K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
53 |
27 |
$10K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
170 |
141 |
$6K |
| K0003 |
Lightweight wheelchair |
552 |
323 |
$5K |
| K0004 |
High strength, lightweight wheelchair |
51 |
29 |
$3K |
| K0001 |
Standard wheelchair |
346 |
212 |
$2K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
25 |
24 |
$2K |
| K0040 |
Adjustable angle footplate, each |
14 |
12 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
28 |
26 |
$841.48 |