| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
159 |
124 |
$8K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
118 |
105 |
$3K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
147 |
130 |
$2K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
21 |
13 |
$929.19 |
| K0001 |
Standard wheelchair |
107 |
106 |
$747.16 |