| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
1,314 |
1,250 |
$153K |
| L3809 |
Whfo w/o joints pre ots |
1,055 |
959 |
$98K |
| L1820 |
Ko elas w/ condyle pads & jo |
1,338 |
1,159 |
$60K |
| L3908 |
Who cock-up nonmolde pre ots |
1,653 |
1,447 |
$44K |
| L4387 |
Non-pneum walk boot pre ots |
358 |
338 |
$30K |
| L3660 |
So 8 ab rstr can/web pre ots |
370 |
360 |
$13K |
| E0114 |
Crutch underarm pair no wood |
413 |
399 |
$10K |
| L1902 |
Afo ankle gauntlet pre ots |
231 |
213 |
$9K |
| L1833 |
Ko adj jnt pos r sup pre ots |
27 |
25 |
$7K |
| K0001 |
Standard wheelchair |
100 |
93 |
$2K |
| L3260 |
Ambulatory surgical boot eac |
76 |
72 |
$362.48 |
| L4350 |
Ankle control ortho pre ots |
13 |
13 |
$297.74 |