| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0005 |
Ultralightweight wheelchair |
661 |
660 |
$168K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
671 |
670 |
$15K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
651 |
650 |
$12K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
172 |
172 |
$11K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
482 |
482 |
$10K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
345 |
344 |
$5K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
434 |
433 |
$5K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
661 |
661 |
$3K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
630 |
629 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
583 |
582 |
$2K |