| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1161 |
Manual adult size wheelchair, includes tilt in space |
688 |
688 |
$43K |
| E2615 |
Positioning wheelchair back cushion, posterior-lateral, width less than 22 inches, any height, including any type mounting hardware |
15 |
15 |
$764.48 |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
42 |
42 |
$600.84 |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
15 |
15 |
$479.85 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
16 |
16 |
$440.46 |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
12 |
12 |
$437.93 |
| K0040 |
Adjustable angle footplate, each |
35 |
19 |
$352.60 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
47 |
47 |
$311.16 |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
16 |
16 |
$243.57 |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
18 |
18 |
$225.37 |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
13 |
12 |
$200.77 |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
16 |
16 |
$165.69 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
14 |
14 |
$63.07 |