| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3908 |
Who cock-up nonmolde pre ots |
3,019 |
2,623 |
$145K |
| L1820 |
Ko elas w/ condyle pads & jo |
1,702 |
1,555 |
$143K |
| L1902 |
Afo ankle gauntlet pre ots |
1,784 |
1,697 |
$111K |
| L3670 |
So acro/clav can web pre ots |
1,593 |
1,502 |
$109K |
| L3260 |
Ambulatory surgical boot eac |
898 |
854 |
$78K |
| L4386 |
Non-pneum walk boot pre cst |
645 |
608 |
$67K |
| L3809 |
Whfo w/o joints pre ots |
168 |
158 |
$25K |
| L4387 |
Non-pneum walk boot pre ots |
190 |
186 |
$19K |
| E0114 |
Crutch underarm pair no wood |
412 |
394 |
$15K |
| A5513 |
Multi den insert custom mold |
86 |
49 |
$6K |
| L1833 |
Ko adj jnt pos r sup pre ots |
15 |
15 |
$5K |
| A5500 |
Diab shoe for density insert |
153 |
75 |
$5K |
| L1830 |
Ko immob canvas long pre ots |
52 |
52 |
$4K |
| A4565 |
Slings |
168 |
166 |
$2K |