| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
9,513 |
1,814 |
$4.66M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
9,200 |
2,633 |
$1.20M |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
4,052 |
2,305 |
$268K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
553 |
434 |
$152K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
3,765 |
2,851 |
$129K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
2,399 |
1,832 |
$108K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
18 |
12 |
$58K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
979 |
756 |
$51K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
17 |
12 |
$46K |
| K0040 |
Adjustable angle footplate, each |
797 |
621 |
$43K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
43 |
41 |
$38K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
285 |
241 |
$32K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
646 |
561 |
$31K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
322 |
226 |
$31K |
| K0005 |
Ultralightweight wheelchair |
32 |
25 |
$28K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,085 |
928 |
$17K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
457 |
347 |
$14K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
45 |
36 |
$5K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
19 |
13 |
$4K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
19 |
13 |
$3K |
| E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
14 |
12 |
$2K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
14 |
12 |
$1K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
54 |
38 |
$638.96 |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
20 |
13 |
$381.30 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
14 |
12 |
$277.33 |