| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
6,333 |
3,094 |
$1.11M |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
1,595 |
1,568 |
$447K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
5,518 |
3,502 |
$401K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
4,360 |
4,055 |
$224K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,451 |
1,216 |
$151K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
2,713 |
2,668 |
$136K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
501 |
496 |
$87K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
275 |
266 |
$67K |
| K0040 |
Adjustable angle footplate, each |
752 |
667 |
$66K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
525 |
506 |
$58K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
692 |
656 |
$46K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
12 |
12 |
$39K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,078 |
1,040 |
$36K |
| K0005 |
Ultralightweight wheelchair |
26 |
25 |
$34K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
218 |
163 |
$24K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
609 |
580 |
$22K |
| E1399 |
Durable medical equipment, miscellaneous |
32 |
12 |
$18K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
339 |
324 |
$14K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
65 |
65 |
$10K |
| K0004 |
High strength, lightweight wheelchair |
138 |
138 |
$10K |
| E2392 |
Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each |
96 |
91 |
$10K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
229 |
208 |
$6K |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
37 |
37 |
$5K |
| E2206 |
Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each |
97 |
87 |
$5K |
| E0950 |
Wheelchair accessory, tray, each |
24 |
24 |
$4K |
| E2624 |
Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
14 |
13 |
$4K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
13 |
13 |
$3K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
40 |
39 |
$2K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
13 |
13 |
$2K |
| K0019 |
Arm pad, replacement only, each |
100 |
93 |
$2K |
| K0077 |
Front caster assembly, complete, with solid tire, replacement only, each |
15 |
13 |
$1K |