| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
3,685 |
756 |
$2.36M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
5,813 |
2,437 |
$568K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
5,656 |
2,709 |
$304K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
1,640 |
1,352 |
$293K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
3,901 |
2,998 |
$160K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
2,704 |
2,170 |
$91K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
940 |
657 |
$67K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
1,139 |
801 |
$41K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
567 |
237 |
$36K |
| E1236 |
Wheelchair, pediatric size, folding, adjustable, with seating system |
37 |
25 |
$29K |
| K0040 |
Adjustable angle footplate, each |
588 |
392 |
$29K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,264 |
926 |
$25K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
592 |
433 |
$22K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
179 |
134 |
$20K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
859 |
560 |
$11K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
52 |
37 |
$10K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
463 |
333 |
$10K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
224 |
163 |
$6K |
| E0950 |
Wheelchair accessory, tray, each |
75 |
64 |
$4K |
| E2622 |
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
35 |
25 |
$4K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
31 |
24 |
$2K |
| E0952 |
Toe loop/holder, any type, each |
136 |
67 |
$2K |
| E0966 |
Manual wheelchair accessory, headrest extension, each |
35 |
25 |
$1K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
14 |
13 |
$668.05 |