| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| G0463 |
Hospital outpt clinic visit |
6,848 |
6,548 |
$1.10M |
| L1960 |
Afo pos solid ank plastic mo |
559 |
478 |
$939K |
| K0739 |
Repair/svc dme non-oxygen eq |
562 |
477 |
$78K |
| L1830 |
Ko immob canvas long pre ots |
164 |
128 |
$25K |
| T1013 |
Sign lang/oral interpreter |
578 |
295 |
$23K |
| K0108 |
W/c component-accessory nos |
148 |
119 |
$16K |
| 64642 |
|
12 |
12 |
$13K |
| E2609 |
Custom fabricate w/c cushion |
15 |
13 |
$13K |
| E2617 |
Custom fab w/c back cushion |
15 |
13 |
$11K |
| 99213 |
|
246 |
229 |
$10K |
| 72082 |
|
150 |
145 |
$9K |
| 99203 |
|
87 |
86 |
$5K |
| L1930 |
Afo plastic |
17 |
12 |
$4K |
| 99212 |
|
167 |
159 |
$4K |
| 76770 |
|
57 |
56 |
$4K |
| 99202 |
|
86 |
85 |
$3K |
| L4002 |
Replace strap, any orthosis |
12 |
12 |
$2K |
| E0960 |
W/c shoulder harness/straps |
15 |
13 |
$576.76 |
| 99214 |
|
58 |
56 |
$0.00 |
| 99215 |
Prolong outpt/office vis |
87 |
77 |
$0.00 |
| 95873 |
|
13 |
12 |
$0.00 |