| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpatient clinic visit for assessment and management of a patient |
8,023 |
7,534 |
$780K |
| E2617 |
Custom fabricated wheelchair back cushion, any size, including any type mounting hardware |
256 |
205 |
$438K |
| E2609 |
Custom fabricated wheelchair seat cushion, any size |
324 |
254 |
$433K |
| J0475 |
Injection, baclofen, 10 mg |
941 |
914 |
$352K |
| 64642 |
|
724 |
681 |
$293K |
| 62369 |
|
1,055 |
1,015 |
$231K |
| K0108 |
Wheelchair component or accessory, not otherwise specified |
794 |
531 |
$118K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
854 |
692 |
$106K |
| L4002 |
Replacement strap, any orthosis, includes all components, any length, any type |
697 |
520 |
$49K |
| J0585 |
Injection, onabotulinumtoxina, 1 unit |
40 |
39 |
$25K |
| 76770 |
|
474 |
460 |
$22K |
| E0960 |
Wheelchair accessory, shoulder harness/straps or chest strap, including any type mounting hardware |
55 |
40 |
$3K |
| E0955 |
Wheelchair accessory, headrest, cushioned, any type, including fixed mounting hardware, each |
16 |
12 |
$3K |
| 95874 |
|
870 |
822 |
$2K |
| 64643 |
|
121 |
115 |
$1K |
| L4205 |
Repair of orthotic device, labor component, per 15 minutes |
27 |
27 |
$953.86 |
| 97530 |
Therapeutic activities, direct patient contact, each 15 minutes |
19 |
12 |
$817.49 |
| L4210 |
Repair of orthotic device, repair or replace minor parts |
12 |
12 |
$44.89 |