| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1399 |
Durable medical equipment, miscellaneous |
1,361 |
1,125 |
$1.90M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
3,732 |
2,967 |
$933K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
1,889 |
1,886 |
$444K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
5,470 |
4,456 |
$372K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
4,483 |
4,378 |
$171K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
2,898 |
2,896 |
$139K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
643 |
642 |
$114K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
499 |
498 |
$105K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,270 |
1,070 |
$99K |
| K0040 |
Adjustable angle footplate, each |
1,438 |
1,258 |
$91K |
| K0005 |
Ultralightweight wheelchair |
37 |
37 |
$42K |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
540 |
540 |
$33K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
808 |
693 |
$33K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
12 |
12 |
$27K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,221 |
1,221 |
$27K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
348 |
347 |
$23K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
14 |
14 |
$22K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
100 |
93 |
$18K |
| 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 |
12 |
12 |
$13K |
| K0077 |
Front caster assembly, complete, with solid tire, replacement only, each |
148 |
138 |
$12K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
274 |
228 |
$12K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
310 |
276 |
$12K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
12 |
12 |
$4K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
12 |
12 |
$4K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
25 |
25 |
$3K |
| E0950 |
Wheelchair accessory, tray, each |
25 |
25 |
$2K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
12 |
12 |
$2K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
81 |
68 |
$1K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
18 |
13 |
$495.76 |
| K0019 |
Arm pad, replacement only, each |
26 |
25 |
$451.71 |