| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
3,186 |
2,836 |
$4.70M |
| E2609 |
Custom fabricated wheelchair seat cushion, any size |
3,321 |
2,946 |
$3.79M |
| E1161 |
Manual adult size wheelchair, includes tilt in space |
1,559 |
1,321 |
$2.13M |
| K0005 |
Ultralightweight wheelchair |
814 |
697 |
$1.28M |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
3,883 |
2,867 |
$1.20M |
| E1007 |
Wheelchair accessory, power seating system, combination tilt and recline, with mechanical shear reduction |
164 |
134 |
$793K |
| E1028 |
Wheelchair accessory, manual swingaway, retractable or removable mounting hardware, other |
4,339 |
3,180 |
$778K |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
2,678 |
2,186 |
$356K |
| 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 |
247 |
204 |
$350K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
2,580 |
2,213 |
$349K |
| E0990 |
Wheelchair accessory, elevating leg rest, complete assembly, each |
1,908 |
1,634 |
$294K |
| K0040 |
Adjustable angle footplate, each |
2,309 |
1,910 |
$250K |
| E2203 |
Manual wheelchair accessory, nonstandard seat frame depth, 20 to less than 22 inches |
619 |
530 |
$229K |
| E0956 |
Wheelchair accessory, lateral trunk or hip support, any type, including fixed mounting hardware, each |
1,396 |
1,148 |
$221K |
| K0861 |
Power wheelchair, group 3 standard, multiple power option, sling/solid seat/back, patient weight capacity up to and including 300 pounds |
44 |
38 |
$178K |
| E1225 |
Wheelchair accessory, manual semi-reclining back, (recline greater than 15 degrees, but less than 80 degrees), each |
1,000 |
863 |
$167K |
| E0971 |
Manual wheelchair accessory, anti-tipping device, each |
2,417 |
2,012 |
$158K |
| E2201 |
Manual wheelchair accessory, nonstandard seat frame, width greater than or equal to 20 inches and less than 24 inches |
489 |
425 |
$141K |
| E2231 |
Manual wheelchair accessory, solid seat support base (replaces sling seat), includes any type mounting hardware |
1,130 |
981 |
$138K |
| E0954 |
Wheelchair accessory, foot box, any type, includes attachment and mounting hardware, each foot |
484 |
339 |
$72K |
| E2377 |
Power wheelchair accessory, expandable controller, including all related electronics and mounting hardware, upgrade provided at initial issue |
223 |
192 |
$63K |
| E1012 |
Wheelchair accessory, addition to power seating system, center mount power elevating leg rest/platform, complete system, any type, each |
51 |
42 |
$63K |
| E0961 |
Manual wheelchair accessory, wheel lock brake extension (handle), each |
1,651 |
1,355 |
$59K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
2,601 |
2,244 |
$57K |
| E2211 |
Manual wheelchair accessory, pneumatic propulsion tire, any size, each |
1,173 |
940 |
$50K |
| E2313 |
Power wheelchair accessory, harness for upgrade to expandable controller, including all fasteners, connectors and mounting hardware, each |
220 |
190 |
$48K |
| E0978 |
Wheelchair accessory, positioning belt/safety belt/pelvic strap, each |
1,286 |
1,121 |
$41K |
| E2361 |
Power wheelchair accessory, 22nf sealed lead acid battery, each, (e.g., gel cell, absorbed glassmat) |
232 |
204 |
$41K |
| E2213 |
Manual wheelchair accessory, insert for pneumatic propulsion tire (removable), any type, any size, each |
857 |
736 |
$41K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
248 |
223 |
$21K |
| E0951 |
Heel loop/holder, any type, with or without ankle strap, each |
449 |
219 |
$6K |
| E2363 |
Power wheelchair accessory, group 24 sealed lead acid battery, each (e.g., gel cell, absorbed glassmat) |
14 |
12 |
$3K |
| E2206 |
Manual wheelchair accessory, wheel lock assembly, complete, replacement only, each |
15 |
13 |
$203.20 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
56 |
50 |
$150.81 |