| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L0650 |
Lso sc r ant/pos pnl pre ots |
1,660 |
1,449 |
$1.24M |
| E0603 |
Electric breast pump |
3,701 |
2,764 |
$579K |
| L0635 |
Lso sagit rigid panel prefab |
824 |
736 |
$521K |
| L0651 |
Lso sag-co shell pnl pre ots |
737 |
419 |
$317K |
| L0488 |
Tlso rigid lined pre one pie |
293 |
287 |
$185K |
| L0648 |
Lso sag r an/pos pnl pre ots |
199 |
158 |
$97K |
| L7362 |
Battery chrgr six volt otto |
531 |
465 |
$74K |
| A4556 |
Electrodes, pair |
160 |
79 |
$27K |
| E0650 |
Pneuma compresor non-segment |
398 |
123 |
$15K |
| A6530 |
Compression stocking bk18-30 |
315 |
265 |
$9K |
| E0730 |
Tens four lead |
647 |
550 |
$6K |
| E0731 |
Conductive garment for tens/ |
625 |
491 |
$6K |
| A4557 |
Lead wires, pair |
667 |
530 |
$5K |
| A4287 |
Disp col sto bag breast milk |
343 |
341 |
$4K |
| K1005 |
Disp col sto bag breast milk |
732 |
337 |
$4K |
| E0676 |
Inter limb compress dev nos |
23 |
13 |
$3K |
| A6549 |
Grad com garm noc day use |
369 |
177 |
$2K |
| E0667 |
Seg pneumatic appl full leg |
41 |
13 |
$1K |
| E0660 |
Pneumatic appliance full leg |
186 |
44 |
$828.91 |
| E0745 |
Neuromuscular stim for shock |
21 |
12 |
$712.93 |
| A4285 |
Replcmnt breast pump bottle |
149 |
117 |
$98.82 |
| A4630 |
Repl bat t.e.n.s. own by pt |
28 |
15 |
$18.07 |
| A4558 |
Conductive gel or paste |
82 |
28 |
$16.22 |
| A4245 |
Alcohol wipes per box |
25 |
15 |
$0.88 |
| A4284 |
Replcmnt breast pump shield |
150 |
118 |
$0.00 |
| A4282 |
Replacement breastpump adpt |
150 |
118 |
$0.00 |
| A4283 |
Replacement breastpump cap |
150 |
118 |
$0.00 |
| A4286 |
Replcmnt breastpump lok ring |
150 |
118 |
$0.00 |
| A4281 |
Replacement breastpump tube |
150 |
118 |
$0.00 |