| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K0108 |
Wheelchair component or accessory, not otherwise specified |
8,114 |
4,835 |
$1.60M |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
2,568 |
2,534 |
$768K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
7,258 |
4,487 |
$469K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
5,616 |
5,379 |
$464K |
| K0005 |
Ultralightweight wheelchair |
211 |
208 |
$257K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
1,905 |
1,691 |
$193K |
| E1399 |
Durable medical equipment, miscellaneous |
185 |
131 |
$170K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
3,102 |
3,049 |
$143K |
| K0040 |
Adjustable angle footplate, each |
1,473 |
1,309 |
$108K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
1,453 |
1,373 |
$80K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
700 |
483 |
$70K |
| E0986 |
Manual wheelchair accessory, power assist system |
176 |
176 |
$68K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
140 |
140 |
$55K |
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
44 |
42 |
$52K |
| E2622 |
Skin protection wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
209 |
207 |
$47K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,814 |
1,776 |
$40K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
628 |
610 |
$37K |
| E2607 |
Skin protection and positioning wheelchair seat cushion, width less than 22 inches, any depth |
205 |
204 |
$35K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
168 |
159 |
$29K |
| E2392 |
Power wheelchair accessory, solid (rubber/plastic) caster tire with integrated wheel, any size, replacement only, each |
305 |
282 |
$29K |
| E0240 |
Bath/shower chair, with or without wheels, any size |
15 |
13 |
$21K |
| E2394 |
Power wheelchair accessory, drive wheel excludes tire, any size, replacement only, each |
235 |
232 |
$19K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
372 |
343 |
$17K |
| E2613 |
Positioning wheelchair back cushion, posterior, width less than 22 inches, any height, including any type mounting hardware |
55 |
55 |
$15K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
637 |
598 |
$13K |
| E2386 |
Power wheelchair accessory, foam filled drive wheel tire, any size, replacement only, each |
78 |
78 |
$13K |
| A4351 |
Intermittent urinary catheter; straight tip, with or without coating (teflon, silicone, or silicone elastomer, etc.), each |
88 |
88 |
$12K |
| E2609 |
Custom fabricated wheelchair seat cushion, any size |
12 |
12 |
$12K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
321 |
309 |
$11K |
| E2620 |
Positioning wheelchair back cushion, planar back with lateral supports, width less than 22 inches, any height, including any type mounting hardware |
36 |
36 |
$9K |
| E2206 |
Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each |
113 |
107 |
$5K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
12 |
12 |
$3K |
| E2363 |
Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
12 |
12 |
$3K |
| K0070 |
Rear wheel assembly, complete, with pneumatic tire, spokes or molded, replacement only, each |
12 |
12 |
$2K |
| E2624 |
Skin protection and positioning wheelchair seat cushion, adjustable, width less than 22 inches, any depth |
12 |
12 |
$2K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
12 |
12 |
$2K |
| K0019 |
Arm pad, replacement only, each |
124 |
109 |
$2K |
| E0950 |
Wheelchair accessory, tray, each |
27 |
27 |
$2K |
| K0004 |
High strength, lightweight wheelchair |
38 |
37 |
$1K |
| K0038 |
Leg strap, each |
37 |
37 |
$659.46 |
| E2210 |
Wheelchair accessory, bearings, any type, replacement only, each |
28 |
27 |
$476.94 |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
13 |
13 |
$448.35 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
25 |
25 |
$81.22 |