| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6539 |
Gc stocking waistlngth 18-30 |
9,930 |
5,030 |
$1.45M |
| L3216 |
Orthoped ladies shoes dpth i |
7,260 |
4,068 |
$433K |
| L3221 |
Orthopedic mens shoes dpth i |
5,622 |
3,460 |
$351K |
| L3000 |
Ft insert ucb berkeley shell |
972 |
478 |
$128K |
| E0603 |
Electric breast pump |
972 |
951 |
$128K |
| A6540 |
Gc stocking waistlngth 30-40 |
608 |
321 |
$98K |
| L3030 |
Foot arch support remov prem |
2,370 |
1,793 |
$88K |
| L3202 |
Oxford w/ supinat/pronator c |
1,162 |
577 |
$61K |
| A6530 |
Compression stocking bk18-30 |
838 |
409 |
$45K |
| L0622 |
Sio flex pelvisacral custom |
264 |
256 |
$33K |
| L3203 |
Oxford w/ supinator/pronator |
584 |
292 |
$25K |
| 97760 |
|
2,189 |
2,188 |
$9K |
| L8310 |
Truss double w/ standard pad |
114 |
106 |
$9K |
| L3020 |
Foot longitud/metatarsal sup |
76 |
70 |
$6K |
| A5500 |
Diab shoe for density insert |
278 |
125 |
$1K |
| A5512 |
Multi den insert direct form |
293 |
135 |
$958.42 |