| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
4,296 |
1,891 |
$913K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
4,123 |
3,811 |
$449K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
156 |
154 |
$314K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
1,198 |
1,102 |
$263K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
1,629 |
1,268 |
$236K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
936 |
922 |
$105K |
| K0004 |
High strength, lightweight wheelchair |
135 |
134 |
$98K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
743 |
732 |
$75K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
301 |
299 |
$53K |
| 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 |
38 |
36 |
$51K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
169 |
166 |
$36K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
12 |
12 |
$33K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
133 |
131 |
$23K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
68 |
67 |
$23K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
280 |
277 |
$18K |
| K0040 |
Adjustable angle footplate, each |
192 |
172 |
$17K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
49 |
49 |
$16K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
50 |
49 |
$11K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
150 |
150 |
$9K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
390 |
386 |
$9K |
| E0295 |
Hospital bed, semi-electric (head and foot adjustment), without side rails, without mattress |
24 |
24 |
$6K |
| E2342 |
Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches |
13 |
13 |
$4K |
| E0156 |
Seat attachment, walker |
229 |
229 |
$4K |
| E1399 |
Durable medical equipment, miscellaneous |
14 |
12 |
$3K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
71 |
70 |
$3K |
| K0056 |
Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair |
41 |
39 |
$2K |