2010 HCPCS Schedule - DE Medical Assistance Program

E0948 FRACTURE FRAME ATTACHMNTS CE 3 $561.19
E0950 TRAY 3 $99.45
E0951 LOOP HEEL 3 $18.02
E0952 TOE LOOP/HOLDER, EACH 3 $18.02
E0953 PNEUMATIC TIRE O $0.00
E0954 WHEELCHAIR SEMI-PNEUMATIC CA O $0.00
E0955 CUSHIONED HEADREST 6 $0.00
E0956 W/C LATERAL TRUNK/HIP SUPPOR 6 $0.00
E0957 W/C MEDIAL THIGH SUPPORT 6 $0.00
E0958 WHLCHR ATT- CONV 1 ARM DRIVE 3 $393.10
E0959 AMPUTEE ADAPTER 3 $84.59
E0960 W/C SHOULDER HARNESS/STRAPS 6 $0.00
E0961 WHEELCHAIR BRAKE EXTENSION 3 $27.82
E0962 WHEELCHAIR 1 INCH CUSHION O $0.00
E0963 WHEELCHAIR 2 INCH CUSHION O $0.00
E0964 WHEELCHAIR 3 INCH CUSHION O $0.00
E0965 WHEELCHAIR 4 INCH CUSHION O $0.00
E0966 WHEELCHAIR HEAD REST EXTENSI 3 $61.94
E0967 MANUAL WC HAND RIM W PROJECT 3 $126.41
E0968 WHEELCHAIR COMMODE SEAT 3 $161.60
E0969 WHEELCHAIR NARROWING DEVICE 3 $139.86
E0970 WHEELCHAIR NO. 2 FOOTPLATES 3 $46.08
E0971 WHEELCHAIR ANTI-TIPPING DEVI 3 $62.90
E0972 TRANSFER BOARD OR DEVICE O $0.00
E0973 W/CH ACCESS DET ADJ ARMREST 3 $109.99
E0974 W/CH ACCESS ANTI-ROLLBACK 3 $75.59
E0975 WHEELCHAIR REINFORCED SEAT U O $0.00
E0976 WHEELCHAIR REINFORCED BACK U O $0.00
E0977 WHEELCHAIR WEDGE CUSHION O $0.00
E0978 W/C ACC,SAF BELT PELV STRAP 3 $42.81
E0979 WHEELCHAIR BELT WITH VELCRO O $0.00
E0980 WHEELCHAIR SAFETY VEST 3 $31.62
E0981 SEAT UPHOLSTERY, REPLACEMENT 6 $0.00
E0982 BACK UPHOLSTERY, REPLACEMENT 6 $0.00
E0983 ADD PWR JOYSTICK 6 $0.00
E0984 ADD PWR TILLER 6 $0.00
E0985 W/C SEAT LIFT MECHANISM 6 $0.00
E0986 MAN W/C PUSH-RIM POW ASSIST 6 $0.00
E0990 WHEELCHAIR ELEVATING LEG RES 3 $112.35
E0991 WHEELCHAIR UPHOLSTRY SEAT O $0.00
E0992 WHEELCHAIR SOLID SEAT INSERT 3 $88.48
E0993 WHEELCHAIR BACK UPHOLSTERY O $0.00
E0994 WHEELCHAIR ARM REST 3 $15.18
E0995 WHEELCHAIR CALF REST 3 $25.29
E0996 WHEELCHAIR TIRE SOLID O $0.00
E0997 WHEELCHAIR CASTER W/ A FORK O $0.00
E0998 WHEELCHAIR CASTER W/O A FORK O $0.00
E0999 WHEELCHR PNEUMATIC TIRE W/WH O $0.00
E1000 WHEELCHAIR TIRE PNEUMATIC CA O $0.00