| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0114 |
Crutch underarm pair no wood |
4,311 |
4,079 |
$141K |
| K0108 |
W/c component-accessory nos |
1,120 |
445 |
$102K |
| L3908 |
Who cock-up nonmolde pre ots |
2,797 |
2,437 |
$101K |
| L4350 |
Ankle control ortho pre ots |
1,175 |
1,118 |
$67K |
| E0143 |
Walker folding wheeled w/o s |
1,517 |
1,400 |
$66K |
| L4387 |
Non-pneum walk boot pre ots |
761 |
706 |
$56K |
| A6530 |
Compression stocking bk18-30 |
707 |
309 |
$31K |
| L3260 |
Ambulatory surgical boot eac |
1,388 |
1,261 |
$25K |
| K0739 |
Repair/svc dme non-oxygen eq |
1,000 |
812 |
$20K |
| A6549 |
Grad com garm noc day use |
275 |
76 |
$20K |
| K0001 |
Standard wheelchair |
1,010 |
862 |
$20K |
| L1830 |
Ko immob canvas long pre ots |
441 |
390 |
$17K |
| L1902 |
Afo ankle gauntlet pre ots |
356 |
319 |
$14K |
| E1028 |
W/c manual swingaway |
133 |
83 |
$11K |
| E0245 |
Tub stool or bench |
178 |
165 |
$9K |
| E0100 |
Cane adjust/fixed with tip |
685 |
642 |
$8K |
| L1820 |
Ko elas w/ condyle pads & jo |
153 |
130 |
$8K |
| E0156 |
Walker seat attachment |
585 |
548 |
$7K |
| L4361 |
Pneuma/vac walk boot pre ots |
50 |
49 |
$6K |
| E0990 |
Wheelchair elevating leg res |
205 |
167 |
$6K |
| E0149 |
Heavy duty wheeled walker |
141 |
111 |
$5K |
| L8000 |
Mastectomy bra |
161 |
138 |
$4K |
| A5500 |
Diab shoe for density insert |
134 |
60 |
$3K |
| A6533 |
Gc stocking thighlngth 18-30 |
29 |
12 |
$2K |
| L8030 |
Breast prosthes w/o adhesive |
14 |
12 |
$1K |
| L3670 |
So acro/clav can web pre ots |
13 |
13 |
$726.10 |
| E0260 |
Hosp bed semi-electr w/ matt |
18 |
13 |
$499.77 |
| E0105 |
Cane adjust/fixed quad/3 pro |
16 |
15 |
$437.55 |
| E0244 |
Toilet seat raised |
15 |
13 |
$354.96 |
| E0135 |
Walker folding adjust/fixed |
13 |
13 |
$335.82 |