| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
13,697 |
12,639 |
$975K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
2,620 |
2,450 |
$234K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
2,797 |
2,467 |
$117K |
| K0822 |
Power wheelchair, group 2 standard, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
1,103 |
962 |
$58K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,533 |
1,319 |
$13K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
5,651 |
5,207 |
$11K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
60 |
44 |
$8K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
497 |
329 |
$7K |
| E2359 |
Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
71 |
64 |
$5K |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
54 |
38 |
$3K |
| E2375 |
Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only |
20 |
14 |
$3K |
| E2381 |
Power wheelchair accessory, pneumatic drive wheel tire, any size, replacement only, each |
89 |
73 |
$2K |
| E1020 |
Residual limb support system for wheelchair, any type |
436 |
267 |
$2K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
191 |
161 |
$812.63 |
| E2391 |
Power wheelchair accessory, solid (rubber/plastic) caster tire (removable), any size, replacement only, each |
75 |
66 |
$770.03 |
| E2382 |
Power wheelchair accessory, tube for pneumatic drive wheel tire, any size, replacement only, each |
27 |
26 |
$388.41 |
| E2208 |
Wheelchair accessory, cylinder tank carrier, each |
13 |
12 |
$264.44 |