| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3670 |
So acro/clav can web pre ots |
533 |
524 |
$20K |
| E0114 |
Crutch underarm pair no wood |
686 |
674 |
$16K |
| L4360 |
Pneumat walking boot pre cst |
157 |
155 |
$14K |
| A9900 |
Supply/accessory/service |
226 |
218 |
$13K |
| E0603 |
Electric breast pump |
52 |
44 |
$7K |
| L1833 |
Ko adj jnt pos r sup pre ots |
14 |
13 |
$3K |
| L3809 |
Whfo w/o joints pre ots |
28 |
28 |
$3K |
| L3908 |
Who cock-up nonmolde pre ots |
116 |
112 |
$3K |
| E0143 |
Walker folding wheeled w/o s |
55 |
54 |
$2K |
| L4361 |
Pneuma/vac walk boot pre ots |
24 |
24 |
$2K |
| A6530 |
Compression stocking bk18-30 |
13 |
12 |
$974.88 |
| L3260 |
Ambulatory surgical boot eac |
13 |
13 |
$120.19 |