| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
250 |
246 |
$27K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
260 |
205 |
$14K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
410 |
397 |
$12K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
218 |
218 |
$11K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
456 |
449 |
$8K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
163 |
161 |
$6K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
127 |
118 |
$3K |
| L0621 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, prefabricated, off-the-shelf |
33 |
33 |
$589.52 |
| L3260 |
Surgical boot/shoe, each |
16 |
16 |
$455.00 |
| A9900 |
Miscellaneous dme supply, accessory, and/or service component of another hcpcs code |
231 |
226 |
$0.00 |