| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,471 |
1,285 |
$171K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,119 |
683 |
$52K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
538 |
521 |
$17K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
378 |
348 |
$12K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
50 |
39 |
$5K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
16 |
12 |
$2K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
52 |
52 |
$2K |
| K0004 |
High strength, lightweight wheelchair |
93 |
92 |
$1K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
12 |
12 |
$714.37 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
101 |
83 |
$339.89 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
12 |
12 |
$35.59 |