| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
389 |
364 |
$62K |
| K0005 |
Ultralightweight wheelchair |
29 |
26 |
$56K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
237 |
220 |
$49K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
12 |
12 |
$31K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
146 |
142 |
$19K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
99 |
96 |
$16K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
53 |
51 |
$14K |
| E2615 |
Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware |
27 |
26 |
$11K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
108 |
100 |
$7K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
12 |
12 |
$6K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
69 |
66 |
$6K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
19 |
14 |
$2K |
| E2603 |
Skin protection wheelchair seat cushion, width less than 22 inches, any depth |
13 |
13 |
$2K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
12 |
12 |
$553.77 |