| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0745 |
Neuromuscular stim for shock |
607 |
583 |
$146K |
| E0731 |
Conductive garment for tens/ |
582 |
564 |
$89K |
| L1832 |
Ko adj jnt pos r sup pre cst |
278 |
204 |
$66K |
| L0631 |
Lso sag r an/pos pnl pre cst |
213 |
204 |
$62K |
| 97140 |
|
6,791 |
1,583 |
$60K |
| 97110 |
|
7,104 |
1,655 |
$55K |
| L0648 |
Lso sag r an/pos pnl pre ots |
146 |
140 |
$50K |
| L3807 |
Whfo w/o joints pre cst |
385 |
269 |
$41K |
| 97014 |
|
1,108 |
246 |
$38K |
| L0651 |
Lso sag-co shell pnl pre ots |
55 |
55 |
$20K |
| L5968 |
Multiaxial ankle w dorsiflex |
17 |
15 |
$20K |
| 97112 |
|
2,031 |
489 |
$19K |
| L0635 |
Lso sagit rigid panel prefab |
45 |
45 |
$18K |
| A4556 |
Electrodes, pair |
625 |
600 |
$14K |
| L5673 |
Socket insert w lock mech |
42 |
34 |
$14K |
| G0283 |
Elec stim other than wound |
462 |
113 |
$12K |
| A4557 |
Lead wires, pair |
663 |
626 |
$12K |
| L0464 |
Tlso 4mod sacro-scap pre |
35 |
32 |
$11K |
| L1833 |
Ko adj jnt pos r sup pre ots |
49 |
31 |
$10K |
| 97161 |
|
333 |
330 |
$9K |
| L5645 |
Bk flex inner socket ext fra |
39 |
30 |
$9K |
| L3010 |
Foot longitudinal arch suppo |
131 |
60 |
$8K |
| L2397 |
Suspension sleeve lower ext |
194 |
156 |
$8K |
| L5910 |
Endo below knee alignable sy |
37 |
29 |
$6K |
| L5671 |
Bk/ak locking mechanism |
40 |
33 |
$6K |
| L3960 |
Sewho airplan desig abdu pos |
14 |
14 |
$5K |
| L5629 |
Below knee acrylic socket |
38 |
30 |
$5K |
| L5637 |
Below knee total contact |
39 |
30 |
$4K |
| L5620 |
Test socket below knee |
39 |
30 |
$4K |
| E0730 |
Tens four lead |
68 |
56 |
$4K |
| L2810 |
Knee control condylar pad |
89 |
72 |
$3K |
| L3760 |
Eo adj jt prefab custom fit |
14 |
13 |
$3K |
| L5704 |
Custom shape cover bk |
15 |
12 |
$3K |
| A4630 |
Repl bat t.e.n.s. own by pt |
556 |
534 |
$3K |
| L3216 |
Orthoped ladies shoes dpth i |
64 |
26 |
$3K |
| L5940 |
Endo bk ultra-light material |
15 |
12 |
$2K |
| L5972 |
Flexible keel foot |
15 |
13 |
$2K |
| L8420 |
Prosthetic sock multi ply bk |
39 |
30 |
$2K |
| L0174 |
Cerv sr 2pc thor ext pre ots |
18 |
17 |
$2K |
| 97164 |
|
87 |
81 |
$1K |
| L2820 |
Soft interface below knee se |
23 |
12 |
$927.66 |
| A5500 |
Diab shoe for density insert |
31 |
12 |
$673.22 |
| A5512 |
Multi den insert direct form |
29 |
12 |
$667.54 |
| L8470 |
Pros sock single ply bk |
39 |
30 |
$415.86 |
| A4595 |
Tens suppl 2 lead per month |
36 |
28 |
$145.48 |