| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
5,447 |
4,607 |
$6.53M |
| E2609 |
Custom fabricated wheelchair seat cushion, any size |
5,545 |
4,689 |
$4.98M |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
2,457 |
2,036 |
$4.50M |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
593 |
445 |
$2.86M |
| K0005 |
Ultralightweight wheelchair |
1,652 |
1,380 |
$2.69M |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
5,410 |
4,402 |
$2.40M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
6,089 |
4,436 |
$1.93M |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
248 |
185 |
$1.04M |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
5,022 |
4,101 |
$948K |
| 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 |
598 |
451 |
$899K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
503 |
376 |
$788K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
4,664 |
3,848 |
$716K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
4,094 |
3,406 |
$650K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
3,742 |
3,079 |
$603K |
| K0040 |
Adjustable angle footplate, each |
4,524 |
3,758 |
$524K |
| E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
1,381 |
1,088 |
$477K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
1,571 |
1,267 |
$458K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
3,229 |
2,695 |
$343K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
4,088 |
3,331 |
$278K |
| E0954 |
Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot |
1,316 |
1,006 |
$263K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
694 |
538 |
$193K |
| E0953 |
Wheelchair accessory, lateral thigh or knee support, any type including fixed mounting hardware, each |
782 |
561 |
$154K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
676 |
518 |
$142K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
2,859 |
2,318 |
$112K |
| E0986 |
Manual wheelchair accessory, power assist system |
27 |
24 |
$107K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
444 |
342 |
$95K |
| K0862 |
Power wheelchair, group 3 heavy duty, multiple power option, sling/solid seat/back, patient weight capacity 301 to 450 pounds |
15 |
13 |
$69K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
1,114 |
952 |
$58K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
1,104 |
983 |
$58K |
| E2363 |
Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
97 |
80 |
$30K |
| E2208 |
Wheelchair accessory, cylinder tank carrier, each |
200 |
155 |
$18K |
| E2624 |
Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
19 |
13 |
$3K |
| E2209 |
Accessory, arm trough, with or without hand support, each |
30 |
25 |
$3K |
| E2218 |
Manual wheelchair accessory, foam propulsion tire, any size, each |
23 |
12 |
$966.90 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
16 |
12 |
$470.00 |