| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
3,218 |
2,795 |
$461K |
| L3809 |
Whfo w/o joints pre ots |
1,527 |
1,335 |
$191K |
| E0114 |
Crutch underarm pair no wood |
6,832 |
5,988 |
$175K |
| L3908 |
Who cock-up nonmolde pre ots |
3,841 |
3,339 |
$104K |
| L1830 |
Ko immob canvas long pre ots |
2,261 |
1,910 |
$86K |
| L3660 |
So 8 ab rstr can/web pre ots |
2,664 |
2,501 |
$78K |
| E0601 |
Cont airway pressure device |
2,334 |
1,844 |
$72K |
| E1390 |
Oxygen concentrator |
1,581 |
1,233 |
$66K |
| L1812 |
Ko elastic w/joints pre ots |
685 |
591 |
$39K |
| L3260 |
Ambulatory surgical boot eac |
1,571 |
1,353 |
$39K |
| L0180 |
Cer post col occ/man sup adj |
206 |
171 |
$30K |
| L1833 |
Ko adj jnt pos r sup pre ots |
79 |
65 |
$24K |
| A7030 |
Cpap full face mask |
558 |
415 |
$22K |
| A7034 |
Nasal application device |
560 |
399 |
$18K |
| L3670 |
So acro/clav can web pre ots |
390 |
335 |
$18K |
| E0562 |
Humidifier heated used w pap |
302 |
231 |
$17K |
| L4387 |
Non-pneum walk boot pre ots |
145 |
130 |
$13K |
| L0464 |
Tlso 4mod sacro-scap pre |
51 |
41 |
$13K |
| A7032 |
Replacement nasal cushion |
584 |
387 |
$12K |
| A7031 |
Replacement facemask interfa |
772 |
534 |
$12K |
| L1902 |
Afo ankle gauntlet pre ots |
160 |
146 |
$8K |
| E0431 |
Portable gaseous 02 |
1,042 |
798 |
$7K |
| L4350 |
Ankle control ortho pre ots |
137 |
125 |
$6K |
| E0570 |
Nebulizer with compression |
735 |
507 |
$5K |
| A7035 |
Pos airway press headgear |
512 |
387 |
$5K |
| A7038 |
Pos airway pressure filter |
2,048 |
1,372 |
$5K |
| K0001 |
Standard wheelchair |
356 |
265 |
$5K |
| A7037 |
Pos airway pressure tubing |
352 |
249 |
$4K |
| E0260 |
Hosp bed semi-electr w/ matt |
163 |
136 |
$3K |
| A7046 |
Repl water chamber, pap dev |
267 |
220 |
$1K |
| L4386 |
Non-pneum walk boot pre cst |
23 |
19 |
$865.76 |
| A7033 |
Replacement nasal pillows |
35 |
27 |
$593.31 |
| E1392 |
Portable oxygen concentrator |
28 |
24 |
$320.63 |
| A4565 |
Slings |
13 |
12 |
$66.22 |
| A7039 |
Filter, non disposable w pap |
16 |
12 |
$36.40 |
| A4604 |
Tubing with heating element |
643 |
474 |
$0.00 |