| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
109 |
76 |
$9K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
113 |
104 |
$8K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
89 |
30 |
$3K |
| K0001 |
Standard wheelchair |
260 |
256 |
$2K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
32 |
24 |
$772.23 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
59 |
29 |
$228.64 |