| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
810 |
315 |
$133K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,040 |
726 |
$88K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
259 |
259 |
$34K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
605 |
539 |
$33K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
649 |
640 |
$28K |
| E1399 |
Durable medical equipment, miscellaneous |
25 |
12 |
$26K |
| K0040 |
Adjustable angle footplate, each |
31 |
24 |
$2K |