| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
199 |
180 |
$81K |
| K0005 |
Ultralightweight wheelchair |
33 |
29 |
$56K |
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
87 |
75 |
$43K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
127 |
111 |
$21K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
107 |
94 |
$20K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
106 |
95 |
$8K |
| E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
18 |
15 |
$8K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
16 |
14 |
$3K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
19 |
18 |
$3K |
| E2603 |
Skin protection wheelchair seat cushion, width less than 22 inches, any depth |
19 |
15 |
$2K |