| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1161 |
Manual adult size wheelchair, includes tilt in space |
2,528 |
2,490 |
$5.34M |
| K0004 |
High strength, lightweight wheelchair |
1,824 |
1,812 |
$2.25M |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
4,428 |
4,373 |
$1.06M |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
4,964 |
4,883 |
$749K |
| E1225 |
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each |
1,744 |
1,717 |
$587K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
3,159 |
2,833 |
$494K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
1,371 |
1,360 |
$459K |
| E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
1,150 |
1,133 |
$386K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
4,928 |
4,841 |
$372K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
2,628 |
2,573 |
$311K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
659 |
654 |
$292K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
1,744 |
1,705 |
$283K |
| K0040 |
Adjustable angle footplate, each |
2,256 |
2,213 |
$271K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
1,549 |
1,462 |
$252K |
| K0053 |
Elevating footrests, articulating (telescoping), each |
1,285 |
1,271 |
$221K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
1,031 |
1,022 |
$150K |
| E2209 |
Accessory, arm trough, with or without hand support, each |
874 |
859 |
$134K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
2,854 |
2,823 |
$127K |
| E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
279 |
279 |
$125K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
3,593 |
3,546 |
$108K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
470 |
470 |
$107K |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
184 |
183 |
$59K |
| E2608 |
Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth |
191 |
190 |
$56K |
| K0005 |
Ultralightweight wheelchair |
25 |
25 |
$42K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
234 |
190 |
$40K |
| E2615 |
Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware |
73 |
70 |
$28K |
| E2612 |
General use wheelchair back cushion, width 22 inches or greater, any height, including any type mounting hardware |
28 |
28 |
$10K |
| E0992 |
Manual wheelchair accessory, solid seat insert |
40 |
39 |
$2K |
| E2219 |
Manual wheelchair accessory, foam caster tire, any size, each |
14 |
14 |
$945.55 |