| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
4,899 |
1,934 |
$5.17M |
| E1399 |
Durable medical equipment, miscellaneous |
4,111 |
761 |
$2.39M |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
1,186 |
897 |
$1.81M |
| K0005 |
Ultralightweight wheelchair |
1,284 |
1,015 |
$1.74M |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
150 |
66 |
$359K |
| E2615 |
Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware |
1,294 |
995 |
$344K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
3,642 |
2,339 |
$256K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
1,577 |
1,169 |
$247K |
| E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
758 |
467 |
$207K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
2,345 |
741 |
$161K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
3,268 |
2,154 |
$134K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
1,183 |
817 |
$112K |
| 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 |
122 |
69 |
$104K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
467 |
298 |
$97K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
1,155 |
692 |
$90K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
265 |
215 |
$65K |
| E8000 |
Gait trainer, pediatric size, posterior support, includes all accessories and components |
292 |
139 |
$64K |
| E2300 |
Wheelchair accessory, power seat elevation system, any type |
60 |
29 |
$62K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
14 |
12 |
$57K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
1,815 |
1,313 |
$54K |
| E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
190 |
134 |
$39K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
433 |
275 |
$39K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
512 |
242 |
$36K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
71 |
54 |
$33K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
1,841 |
1,321 |
$32K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
165 |
79 |
$26K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
160 |
77 |
$20K |
| E2622 |
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
100 |
72 |
$18K |
| E2298 |
Complex rehabilitative power wheelchair accessory, power seat elevation system, any type |
20 |
13 |
$16K |
| E0261 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, without mattress |
202 |
193 |
$15K |
| K0040 |
Adjustable angle footplate, each |
221 |
131 |
$12K |
| E0953 |
Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each |
213 |
53 |
$5K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
130 |
55 |
$4K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
76 |
75 |
$4K |
| E2359 |
Power wheelchair accessory, group 34 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
15 |
13 |
$3K |
| E0950 |
Wheelchair accessory, tray, each |
54 |
37 |
$3K |
| E2363 |
Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
14 |
12 |
$2K |
| K0004 |
High strength, lightweight wheelchair |
95 |
94 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
131 |
99 |
$2K |
| E2603 |
Skin protection wheelchair seat cushion, width less than 22 inches, any depth |
18 |
15 |
$1K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
27 |
14 |
$861.00 |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
21 |
12 |
$773.96 |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
21 |
15 |
$700.00 |