| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
5,602 |
4,790 |
$13.31M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
9,344 |
7,147 |
$4.86M |
| K0009 |
Other manual wheelchair/base |
247 |
236 |
$1.27M |
| E0240 |
Bath/shower chair, with or without wheels, any size |
636 |
613 |
$1.12M |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
2,565 |
2,204 |
$613K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
8,927 |
4,365 |
$563K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
276 |
255 |
$340K |
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
360 |
313 |
$306K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
2,277 |
1,519 |
$234K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
1,198 |
1,071 |
$219K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
4,063 |
3,518 |
$180K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,838 |
1,487 |
$155K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
8,490 |
7,739 |
$151K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
2,214 |
2,163 |
$135K |
| E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
526 |
467 |
$125K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
2,322 |
2,100 |
$123K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,892 |
1,516 |
$102K |
| K0005 |
Ultralightweight wheelchair |
80 |
70 |
$91K |
| E8001 |
Gait trainer, pediatric size, upright support, includes all accessories and components |
29 |
29 |
$80K |
| E0637 |
Combination sit to stand frame/table system, any size including pediatric, with seat lift feature, with or without wheels |
16 |
13 |
$78K |
| K0040 |
Adjustable angle footplate, each |
1,021 |
791 |
$48K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
440 |
380 |
$45K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
1,435 |
1,116 |
$37K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,568 |
1,417 |
$30K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
1,248 |
891 |
$21K |
| E1238 |
Wheelchair, pediatric size, folding, adjustable, without seating system |
17 |
15 |
$21K |
| E0966 |
Manual wheelchair accessory, headrest extension, each |
376 |
366 |
$19K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
590 |
516 |
$18K |
| E2292 |
Seat, planar, for pediatric size wheelchair including fixed attaching hardware |
59 |
57 |
$14K |
| E2219 |
Manual wheelchair accessory, foam caster tire, any size, each |
192 |
164 |
$9K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
42 |
41 |
$7K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
97 |
79 |
$5K |
| E0957 |
Wheelchair accessory, medial thigh support, any type, including fixed mounting hardware, each |
62 |
55 |
$5K |
| E2291 |
Back, planar, for pediatric size wheelchair including fixed attaching hardware |
16 |
16 |
$4K |
| E2619 |
Replacement cover for wheelchair seat cushion or back cushion, each |
26 |
24 |
$870.63 |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
12 |
12 |
$848.01 |
| E2206 |
Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each |
23 |
15 |
$703.80 |
| K0038 |
Leg strap, each |
14 |
12 |
$218.46 |