| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1161 |
Manual adult size wheelchair, includes tilt in space |
278 |
276 |
$409K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
375 |
317 |
$67K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
483 |
456 |
$54K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
282 |
279 |
$40K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
54 |
54 |
$28K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
248 |
247 |
$28K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
270 |
261 |
$22K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
125 |
74 |
$20K |
| E2624 |
Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
27 |
27 |
$9K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
58 |
57 |
$5K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
36 |
36 |
$3K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
14 |
14 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
25 |
25 |
$883.09 |