| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2370 |
Power wheelchair component, integrated drive wheel motor and gear box combination, replacement only |
859 |
604 |
$115K |
| E2375 |
Power wheelchair accessory, non-expandable controller, including all related electronics and mounting hardware, replacement only |
872 |
866 |
$112K |
| 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 |
650 |
647 |
$63K |
| E2369 |
Power wheelchair component, drive wheel gear box, replacement only |
302 |
270 |
$37K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
3,745 |
2,309 |
$31K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
825 |
592 |
$23K |
| E2366 |
Power wheelchair accessory, battery charger, single mode, for use with only one battery type, sealed or non-sealed, each |
753 |
745 |
$22K |
| E2392 |
Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each |
748 |
741 |
$17K |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
823 |
589 |
$13K |
| E2368 |
Power wheelchair component, drive wheel motor, replacement only |
57 |
54 |
$8K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
139 |
129 |
$8K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
300 |
224 |
$4K |
| K0462 |
Temporary replacement for patient owned equipment being repaired, any type |
1,717 |
1,670 |
$3K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
46 |
46 |
$1K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
29 |
29 |
$1K |
| E2395 |
Power wheelchair accessory, caster wheel excludes tire, any size, replacement only, each |
32 |
32 |
$947.32 |
| E2396 |
Power wheelchair accessory, caster fork, any size, replacement only, each |
47 |
45 |
$620.80 |
| E2387 |
Power wheelchair accessory, foam filled caster tire, any size, replacement only, each |
12 |
12 |
$323.59 |
| E2365 |
Power wheelchair accessory, u-1 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
729 |
724 |
$135.22 |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
1,524 |
1,094 |
$87.60 |