Dynamic List Information
Dynamic List Data
HCPCS Code
E1234
On Master List?
Yes
Prior Authorization Required?
No
PA Effective Dates
N/A
F2F and Written Order Prior to Delivery?
No
F2F and WOPD Effective Dates
N/A
Description: Wheelchair, pediatric size, tilt-in-space, folding, adjustable, without seating system