| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
2,009 |
1,676 |
$708K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
2,172 |
1,432 |
$648K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
1,251 |
1,166 |
$201K |
| T2029 |
Specialized medical equipment, not otherwise specified, waiver |
172 |
168 |
$186K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,151 |
1,053 |
$151K |
| K0040 |
Adjustable angle footplate, each |
1,047 |
946 |
$122K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
405 |
373 |
$70K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
2,484 |
2,214 |
$65K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
881 |
816 |
$51K |
| Z0160 |
|
391 |
332 |
$45K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
170 |
160 |
$42K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
446 |
414 |
$35K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
658 |
602 |
$33K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
949 |
892 |
$30K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
111 |
102 |
$20K |
| E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
42 |
40 |
$14K |
| E2210 |
Wheelchair accessory, bearings, any type, replacement only, each |
315 |
281 |
$8K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
61 |
54 |
$8K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
13 |
12 |
$6K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
249 |
222 |
$5K |
| K0070 |
Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each |
15 |
13 |
$5K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
147 |
131 |
$3K |
| E2395 |
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
13 |
12 |
$1K |
| E0953 |
Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each |
16 |
13 |
$1K |
| E2205 |
Manual wheelchair accessory, handrim without projections (includes ergonomic or contoured), any type, replacement only, each |
13 |
12 |
$742.82 |