| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
3,348 |
2,304 |
$9.04M |
| 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 |
3,922 |
2,735 |
$2.94M |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
1,164 |
775 |
$2.50M |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
21,231 |
15,405 |
$901K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
8,707 |
4,256 |
$625K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
6,458 |
5,355 |
$569K |
| K0842 |
Power wheelchair, group 2 standard, multiple power option, captains chair, patient weight capacity up to and including 300 pounds |
793 |
536 |
$558K |
| K0821 |
Power wheelchair, group 2 standard, portable, captains chair, patient weight capacity up to and including 300 pounds |
7,615 |
6,601 |
$513K |
| E1002 |
Wheelchair accessory, power seating system, tilt only |
300 |
228 |
$438K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
3,328 |
2,286 |
$409K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
5,217 |
3,344 |
$370K |
| E1223 |
Wheelchair with detachable arms, footrests |
437 |
365 |
$328K |
| K0825 |
Power wheelchair, group 2 heavy duty, captains chair, patient weight capacity 301 to 450 pounds |
2,455 |
2,123 |
$302K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
4,168 |
2,956 |
$229K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
990 |
652 |
$165K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
2,144 |
1,498 |
$84K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
1,035 |
650 |
$80K |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
2,051 |
1,468 |
$79K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,362 |
686 |
$51K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,582 |
861 |
$45K |
| E2611 |
General use wheelchair back cushion, width less than 22 inches, any height, including any type mounting hardware |
714 |
476 |
$30K |
| K0040 |
Adjustable angle footplate, each |
1,065 |
565 |
$25K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
3,486 |
2,560 |
$20K |
| E1399 |
Durable medical equipment, miscellaneous |
429 |
230 |
$20K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,144 |
630 |
$19K |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
456 |
403 |
$18K |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
306 |
238 |
$14K |
| 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 |
65 |
55 |
$11K |
| K0005 |
Ultralightweight wheelchair |
90 |
66 |
$8K |
| E2363 |
Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
51 |
28 |
$7K |
| E2601 |
General use wheelchair seat cushion, width less than 22 inches, any depth |
500 |
325 |
$7K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,053 |
728 |
$7K |
| E2608 |
Skin protection and positioning wheelchair seat cushion, width 22 inches or greater, any depth |
52 |
27 |
$6K |
| E2621 |
Positioning wheelchair back cushion, planar back with lateral supports, width 22 inches or greater, any height, including any type mounting hardware |
22 |
13 |
$5K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
729 |
383 |
$3K |
| E1240 |
Lightweight wheelchair, detachable arms, (desk or full length) swing away detachable, elevating legrest |
292 |
274 |
$3K |
| E2603 |
Skin protection wheelchair seat cushion, width less than 22 inches, any depth |
39 |
31 |
$3K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
72 |
27 |
$2K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
402 |
217 |
$2K |
| E0953 |
Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each |
90 |
38 |
$2K |
| E1090 |
High strength lightweight wheelchair, detachable arms desk or full length, swing away detachable foot rests |
205 |
199 |
$2K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
16 |
12 |
$1K |
| E1020 |
Residual limb support system for wheelchair, any type |
25 |
24 |
$604.05 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
736 |
635 |
$495.49 |
| E1295 |
Heavy duty wheelchair, fixed full length arms, elevating legrest |
26 |
25 |
$465.79 |
| E2392 |
Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each |
25 |
12 |
$332.96 |
| K0019 |
Arm pad, replacement only, each |
35 |
25 |
$241.22 |
| K0003 |
Lightweight wheelchair |
373 |
340 |
$151.34 |
| K0004 |
High strength, lightweight wheelchair |
208 |
204 |
$140.30 |
| K0001 |
Standard wheelchair |
13 |
12 |
$0.00 |