| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1161 |
Manual adult size wheelchair, includes tilt in space |
4,097 |
4,054 |
$279K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
4,538 |
4,125 |
$15K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
4,181 |
4,113 |
$14K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
4,223 |
4,158 |
$11K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
285 |
253 |
$7K |
| K0004 |
High strength, lightweight wheelchair |
251 |
251 |
$6K |
| K0040 |
Adjustable angle footplate, each |
275 |
200 |
$5K |
| K0005 |
Ultralightweight wheelchair |
24 |
24 |
$5K |
| K0003 |
Lightweight wheelchair |
243 |
242 |
$4K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
297 |
270 |
$2K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
254 |
236 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
223 |
220 |
$1K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
228 |
196 |
$1K |
| E2218 |
Manual wheelchair accessory, foam propulsion tire, any size, each |
64 |
45 |
$529.34 |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
13 |
13 |
$330.52 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
12 |
12 |
$131.32 |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
15 |
13 |
$117.02 |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
13 |
13 |
$102.44 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
13 |
13 |
$42.78 |