| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
3,550 |
2,413 |
$14.64M |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
8,396 |
5,497 |
$10.64M |
| E2609 |
Custom fabricated wheelchair seat cushion, any size |
13,003 |
8,856 |
$9.16M |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
2,475 |
1,642 |
$7.67M |
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
12,881 |
8,794 |
$7.27M |
| 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 |
3,621 |
2,465 |
$4.18M |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
3,018 |
1,982 |
$3.26M |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
20,210 |
8,981 |
$2.71M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
11,717 |
6,128 |
$1.90M |
| K0005 |
Ultralightweight wheelchair |
1,333 |
838 |
$1.64M |
| E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
5,782 |
3,781 |
$1.59M |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
12,369 |
8,080 |
$1.39M |
| E2204 |
Manual wheelchair accessory, nonstandard seat frame depth, 22 to 25 inches |
2,546 |
1,713 |
$1.18M |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
11,812 |
7,729 |
$1.11M |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
9,064 |
5,927 |
$994K |
| K0040 |
Adjustable angle footplate, each |
12,029 |
7,867 |
$979K |
| K0862 |
Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
289 |
160 |
$877K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
4,037 |
2,706 |
$868K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
8,294 |
4,453 |
$839K |
| E1002 |
Wheelchair accessory, power seating system, tilt only |
443 |
263 |
$822K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
9,179 |
5,989 |
$767K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
3,731 |
2,516 |
$765K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
3,764 |
2,533 |
$588K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
3,248 |
2,231 |
$519K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
9,249 |
6,032 |
$453K |
| E0954 |
Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot |
3,943 |
2,352 |
$445K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
8,174 |
5,439 |
$307K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
8,482 |
5,626 |
$281K |
| E2363 |
Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
1,058 |
669 |
$221K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
6,311 |
4,164 |
$176K |
| E1225 |
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each |
966 |
519 |
$141K |
| E0953 |
Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each |
660 |
391 |
$110K |
| E1010 |
Wheelchair accessory, addition to power seating system, power leg elevation system, including leg rest, pair |
187 |
139 |
$107K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
4,929 |
3,438 |
$100K |
| E2343 |
Power wheelchair accessory, nonstandard seat frame depth, 22-25 inches |
243 |
134 |
$87K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
4,441 |
3,158 |
$76K |
| E2342 |
Power wheelchair accessory, nonstandard seat frame depth, 20 or 21 inches |
184 |
117 |
$43K |
| E2208 |
Wheelchair accessory, cylinder tank carrier, each |
511 |
286 |
$33K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
2,541 |
996 |
$33K |
| K0056 |
Seat height less than 17" or equal to or greater than 21" for a high strength, lightweight, or ultralightweight wheelchair |
529 |
314 |
$27K |
| E2340 |
Power wheelchair accessory, nonstandard seat frame width, 20-23 inches |
151 |
90 |
$27K |
| E2206 |
Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each |
1,238 |
823 |
$21K |
| E0950 |
Wheelchair accessory, tray, each |
248 |
172 |
$12K |
| E2341 |
Power wheelchair accessory, nonstandard seat frame width, 24-27 inches |
25 |
13 |
$10K |
| E2202 |
Manual wheelchair accessory, nonstandard seat frame width, 24-27 inches |
23 |
14 |
$8K |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
75 |
58 |
$7K |
| E2209 |
Accessory, arm trough, with or without hand support, each |
54 |
28 |
$4K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
41 |
24 |
$679.11 |
| K0019 |
Arm pad, replacement only, each |
20 |
12 |
$236.05 |