| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1002 |
Wheelchair accessory, power seating system, tilt only |
657 |
551 |
$853K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
15,810 |
11,819 |
$849K |
| 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 |
828 |
676 |
$599K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
762 |
647 |
$359K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
3,399 |
2,647 |
$339K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
5,348 |
3,044 |
$266K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
1,216 |
1,084 |
$233K |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
54 |
43 |
$167K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
1,050 |
875 |
$163K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
1,677 |
1,313 |
$152K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
4,284 |
2,207 |
$126K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
2,627 |
2,091 |
$104K |
| K0816 |
Power wheelchair, group 1 standard, captains chair, patient weight capacity up to and including 300 pounds |
2,793 |
2,743 |
$100K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
2,359 |
1,844 |
$90K |
| E2298 |
Complex rehabilitative power wheelchair accessory, power seat elevation system, any type |
166 |
161 |
$68K |
| K0835 |
Power wheelchair, group 2 standard, single power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
34 |
29 |
$62K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
36 |
29 |
$60K |
| K0836 |
Power wheelchair, group 2 standard, single power option, captains chair, patient weight capacity up to and including 300 pounds |
64 |
63 |
$52K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
260 |
211 |
$38K |
| K0040 |
Adjustable angle footplate, each |
1,011 |
571 |
$37K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
257 |
213 |
$28K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,683 |
1,308 |
$24K |
| K0003 |
Lightweight wheelchair |
2,015 |
1,845 |
$23K |
| K0001 |
Standard wheelchair |
2,375 |
2,203 |
$21K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
110 |
88 |
$15K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
837 |
483 |
$15K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
55 |
55 |
$13K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
242 |
208 |
$12K |
| E2300 |
Wheelchair accessory, power seat elevation system, any type |
20 |
18 |
$10K |
| K0005 |
Ultralightweight wheelchair |
13 |
12 |
$9K |
| K0002 |
Standard hemi (low seat) wheelchair |
757 |
705 |
$7K |
| L0648 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
41 |
38 |
$6K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
648 |
512 |
$5K |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
2,104 |
1,832 |
$4K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
37 |
26 |
$3K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
184 |
165 |
$3K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
36 |
30 |
$3K |
| E1225 |
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each |
18 |
12 |
$2K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
163 |
160 |
$2K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
46 |
40 |
$2K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
62 |
37 |
$1K |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
16 |
13 |
$683.55 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
48 |
25 |
$651.72 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
76 |
41 |
$621.99 |
| E1088 |
High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable elevating leg rests |
103 |
96 |
$494.83 |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
25 |
13 |
$370.76 |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
15 |
12 |
$178.10 |
| E0156 |
Seat attachment, walker |
15 |
15 |
$40.29 |