| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
272 |
236 |
$19K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
204 |
167 |
$17K |
| K0003 |
Lightweight wheelchair |
316 |
273 |
$6K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
173 |
90 |
$5K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
84 |
78 |
$5K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
363 |
176 |
$4K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
211 |
156 |
$3K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
125 |
38 |
$2K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
37 |
28 |
$1K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
35 |
24 |
$1K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
54 |
30 |
$1K |
| K0004 |
High strength, lightweight wheelchair |
30 |
25 |
$645.49 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
55 |
37 |
$510.81 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
57 |
32 |
$459.51 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
204 |
172 |
$416.95 |
| K0001 |
Standard wheelchair |
32 |
26 |
$178.08 |