| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
522 |
521 |
$213K |
| K0003 |
Lightweight wheelchair |
5,357 |
5,329 |
$63K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
403 |
259 |
$40K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
614 |
609 |
$39K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
1,669 |
1,659 |
$31K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
12 |
12 |
$21K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
597 |
561 |
$17K |
| E0245 |
Tub stool or bench |
251 |
249 |
$14K |
| E0156 |
Seat attachment, walker |
1,306 |
1,302 |
$8K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
530 |
495 |
$7K |
| E2311 |
Power wheelchair accessory, electronic connection between wheelchair controller and two or more power seating system motors, including all related electronics, indicator feature, mechanical function selection switch, and fixed mounting hardware |
12 |
12 |
$6K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
1,384 |
1,114 |
$5K |
| K0005 |
Ultralightweight wheelchair |
96 |
96 |
$4K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
462 |
428 |
$4K |
| E0372 |
Powered air overlay for mattress, standard mattress length and width |
93 |
79 |
$3K |
| E1010 |
Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair |
12 |
12 |
$3K |
| L2810 |
Addition to lower extremity orthosis, knee control, condylar pad |
117 |
67 |
$2K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
26 |
25 |
$1K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
12 |
12 |
$1K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
40 |
24 |
$1K |
| L0464 |
Tlso, triplanar control, modular segmented spinal system, four rigid plastic shells, posterior extends from sacrococcygeal junction and terminates just inferior to scapular spine, anterior extends from symphysis pubis to the sternal notch, soft liner, restricts gross trunk motion in sagittal, coronal, and transverse planes, lateral strength is provided by overlapping plastic and stabilizing closures, includes straps and closures, prefabricated, includes fitting and adjustment |
65 |
65 |
$1K |
| L3170 |
Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each |
39 |
39 |
$809.80 |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
12 |
12 |
$631.11 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
124 |
124 |
$242.04 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
96 |
96 |
$89.94 |
| L0651 |
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf |
96 |
96 |
$64.62 |