| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
856 |
498 |
$924K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
3,514 |
2,393 |
$302K |
| E1002 |
Wheelchair accessory, power seating system, tilt only |
299 |
278 |
$184K |
| 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 |
997 |
589 |
$155K |
| K0005 |
Ultralightweight wheelchair |
437 |
321 |
$151K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
3,576 |
1,745 |
$76K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
68 |
39 |
$65K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
1,813 |
1,138 |
$55K |
| K0835 |
Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
120 |
115 |
$44K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
1,622 |
1,136 |
$30K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
708 |
402 |
$26K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
374 |
315 |
$21K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
816 |
472 |
$17K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
345 |
296 |
$13K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
276 |
157 |
$11K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
916 |
454 |
$10K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
83 |
76 |
$10K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
703 |
375 |
$7K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
241 |
171 |
$7K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
874 |
410 |
$6K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
226 |
160 |
$5K |
| K0040 |
Adjustable angle footplate, each |
588 |
279 |
$5K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,012 |
740 |
$5K |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
74 |
66 |
$3K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
256 |
185 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
367 |
172 |
$2K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
40 |
28 |
$2K |
| E2603 |
Skin protection wheelchair seat cushion, width less than 22 inches, any depth |
128 |
115 |
$1K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
659 |
306 |
$1K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
212 |
168 |
$1K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
112 |
55 |
$493.76 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
95 |
81 |
$229.92 |
| K0019 |
Arm pad, replacement only, each |
21 |
13 |
$94.25 |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
91 |
41 |
$64.82 |