| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2370 |
Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only |
2,038 |
1,064 |
$161K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,789 |
876 |
$107K |
| E2375 |
Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only |
1,134 |
1,102 |
$107K |
| E2374 |
Power wheelchair accessory, hand or chin control interface, standard remote joystick (not including controller), proportional, including all related electronics and fixed mounting hardware, replacement only |
1,071 |
1,044 |
$85K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
2,605 |
1,287 |
$56K |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
1,282 |
1,235 |
$42K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,263 |
669 |
$35K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
4,326 |
2,256 |
$33K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
705 |
674 |
$27K |
| E2395 |
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
2,625 |
1,195 |
$23K |
| K0462 |
Temporary replacement for patient owned equipment being repaired, any type |
297 |
293 |
$20K |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
1,248 |
619 |
$15K |
| E2389 |
Power wheelchair accessory, foam caster tire, any size, replacement only, each |
1,475 |
665 |
$10K |
| E2387 |
Power wheelchair accessory, foam filled caster tire, any size, replacement only, each |
865 |
411 |
$9K |
| E2210 |
Wheelchair accessory, bearings, any type, replacement only, each |
1,306 |
1,272 |
$8K |
| E2396 |
Power wheelchair accessory, caster fork, any size, replacement only, each |
822 |
378 |
$8K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
159 |
157 |
$2K |
| K0040 |
Adjustable angle footplate, each |
205 |
150 |
$2K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
347 |
334 |
$2K |
| E2392 |
Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each |
189 |
92 |
$2K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
14 |
14 |
$588.68 |
| K0019 |
Arm pad, replacement only, each |
55 |
27 |
$29.46 |