| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S1040 |
Cranial remolding orthosis |
775 |
771 |
$1.07M |
| L3020 |
Foot longitud/metatarsal sup |
3,126 |
1,622 |
$384K |
| L1970 |
Afo plastic molded w/ankle j |
939 |
526 |
$372K |
| A5500 |
Diab shoe for density insert |
6,953 |
3,861 |
$331K |
| L4387 |
Non-pneum walk boot pre ots |
3,630 |
3,596 |
$331K |
| A6530 |
Compression stocking bk18-30 |
13,869 |
9,254 |
$328K |
| L2280 |
Molded inner boot |
922 |
451 |
$290K |
| L2275 |
Plastic mod low ext pad/line |
3,716 |
1,890 |
$275K |
| A5512 |
Multi den insert direct form |
4,070 |
2,113 |
$226K |
| A5513 |
Multi den insert custom mold |
3,010 |
1,622 |
$214K |
| L3908 |
Who cock-up nonmolde pre ots |
5,209 |
3,996 |
$200K |
| L1820 |
Ko elas w/ condyle pads & jo |
2,395 |
2,150 |
$195K |
| L3809 |
Whfo w/o joints pre ots |
1,225 |
1,142 |
$161K |
| L4361 |
Pneuma/vac walk boot pre ots |
1,052 |
1,030 |
$153K |
| L2820 |
Soft interface below knee se |
3,013 |
1,606 |
$137K |
| A6533 |
Gc stocking thighlngth 18-30 |
3,526 |
2,390 |
$127K |
| L1960 |
Afo pos solid ank plastic mo |
215 |
120 |
$78K |
| L1830 |
Ko immob canvas long pre ots |
1,676 |
1,579 |
$73K |
| L1902 |
Afo ankle gauntlet pre ots |
1,631 |
1,570 |
$70K |
| L4386 |
Non-pneum walk boot pre cst |
747 |
733 |
$68K |
| E0114 |
Crutch underarm pair no wood |
2,383 |
2,368 |
$60K |
| L3807 |
Whfo w/o joints pre cst |
304 |
262 |
$40K |
| A6531 |
Compress stking bk30-40 surg |
1,107 |
823 |
$31K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
136 |
136 |
$30K |
| L1833 |
Ko adj jnt pos r sup pre ots |
69 |
68 |
$27K |
| L8000 |
Mastectomy bra |
422 |
381 |
$16K |
| L2200 |
Limited ankle motion ea jnt |
261 |
150 |
$15K |
| L1832 |
Ko adj jnt pos r sup pre cst |
24 |
24 |
$9K |
| L1907 |
Afo supramalleolar custom |
25 |
13 |
$8K |
| L3260 |
Ambulatory surgical boot eac |
167 |
165 |
$7K |
| E0143 |
Walker folding wheeled w/o s |
79 |
79 |
$5K |
| L4350 |
Ankle control ortho pre ots |
73 |
73 |
$4K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
19 |
19 |
$4K |
| E0100 |
Cane adjust/fixed with tip |
322 |
322 |
$4K |
| L4397 |
Static or dynami afo pre ots |
30 |
24 |
$3K |
| L3670 |
So acro/clav can web pre ots |
25 |
24 |
$1K |
| L4396 |
Static or dynami afo pre cst |
15 |
13 |
$1K |
| E0156 |
Walker seat attachment |
66 |
66 |
$866.48 |
| A6534 |
Gc stocking thighlngth 30-40 |
15 |
13 |
$599.70 |