| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0005 |
Ultralightweight wheelchair |
21 |
12 |
$21K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
209 |
80 |
$5K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
50 |
26 |
$867.66 |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
55 |
28 |
$782.51 |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
14 |
13 |
$726.30 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
51 |
27 |
$559.29 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
24 |
12 |
$337.26 |
| K0040 |
Adjustable angle footplate, each |
41 |
12 |
$158.95 |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
21 |
13 |
$63.75 |
| K0004 |
High strength, lightweight wheelchair |
19 |
12 |
$62.50 |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
17 |
12 |
$0.00 |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
19 |
12 |
$0.00 |