| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
781 |
354 |
$776K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
540 |
245 |
$121K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,060 |
567 |
$96K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
620 |
474 |
$16K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
101 |
64 |
$8K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
104 |
91 |
$3K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
14 |
13 |
$988.26 |