| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
186,895 |
163,241 |
$25.70M |
| E0748 |
Elec osteogen stim spinal |
13,154 |
10,961 |
$21.57M |
| E0747 |
Elec osteogen stim not spine |
7,494 |
6,638 |
$14.27M |
| L1833 |
Ko adj jnt pos r sup pre ots |
38,905 |
33,823 |
$10.77M |
| L3809 |
Whfo w/o joints pre ots |
60,928 |
53,441 |
$6.55M |
| L3984 |
Upper ext fx orthosis wrist |
36,396 |
33,520 |
$6.41M |
| L3908 |
Who cock-up nonmolde pre ots |
169,232 |
142,212 |
$5.23M |
| L1846 |
Ko w adj flex/ext rotat mold |
8,305 |
6,595 |
$4.28M |
| L1852 |
Ko double upright prefab ots |
10,670 |
8,618 |
$4.10M |
| L3660 |
So 8 ab rstr can/web pre ots |
65,846 |
59,128 |
$3.08M |
| E0114 |
Crutch underarm pair no wood |
104,023 |
96,573 |
$3.03M |
| L1902 |
Afo ankle gauntlet pre ots |
65,345 |
56,678 |
$2.59M |
| L1820 |
Ko elas w/ condyle pads & jo |
38,676 |
32,671 |
$2.46M |
| L1812 |
Ko elastic w/joints pre ots |
49,527 |
40,691 |
$2.43M |
| L4387 |
Non-pneum walk boot pre ots |
19,439 |
17,178 |
$1.63M |
| L0650 |
Lso sc r ant/pos pnl pre ots |
3,272 |
2,927 |
$1.57M |
| L4350 |
Ankle control ortho pre ots |
31,001 |
27,528 |
$1.46M |
| L2795 |
Knee control full kneecap |
31,338 |
25,512 |
$1.27M |
| L1830 |
Ko immob canvas long pre ots |
26,408 |
23,225 |
$1.13M |
| L3670 |
So acro/clav can web pre ots |
18,042 |
16,112 |
$900K |
| L3761 |
Eo, adj lock joint prefab ot |
3,716 |
3,293 |
$801K |
| L3260 |
Ambulatory surgical boot eac |
38,789 |
32,332 |
$669K |
| L3924 |
Hfo without joints pre ots |
14,761 |
12,326 |
$546K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
2,499 |
2,246 |
$434K |
| L2755 |
Carbon graphite lamination |
5,709 |
4,410 |
$422K |
| L4397 |
Static or dynami afo pre ots |
4,808 |
4,047 |
$371K |
| L4360 |
Pneumat walking boot pre cst |
3,202 |
2,938 |
$365K |
| L1686 |
Ho post-op hip abduction |
750 |
638 |
$337K |
| E0143 |
Walker folding wheeled w/o s |
7,233 |
6,553 |
$266K |
| L0464 |
Tlso 4mod sacro-scap pre |
273 |
248 |
$211K |
| L3995 |
Sock fracture or equal each |
10,609 |
9,820 |
$204K |
| L3980 |
Up ext fx orthos humeral nos |
1,274 |
1,149 |
$197K |
| L1832 |
Ko adj jnt pos r sup pre cst |
669 |
612 |
$164K |
| L2830 |
Soft interface above knee se |
4,961 |
3,848 |
$159K |
| L2820 |
Soft interface below knee se |
4,977 |
3,864 |
$158K |
| A4565 |
Slings |
25,273 |
22,332 |
$150K |
| L0174 |
Cerv sr 2pc thor ext pre ots |
1,326 |
1,148 |
$149K |
| L1851 |
Ko single upright prefab ots |
505 |
394 |
$138K |
| A4467 |
Belt strap sleev grmnt cover |
7,584 |
5,454 |
$121K |
| L3265 |
Plastazote sandal each |
8,521 |
6,635 |
$109K |
| L3807 |
Whfo w/o joints pre cst |
937 |
868 |
$91K |
| L1810 |
Ko elastic with joints |
1,726 |
1,533 |
$89K |
| L0648 |
Lso sag r an/pos pnl pre ots |
187 |
150 |
$69K |
| L1620 |
Ho flex pavlik harns pre cst |
710 |
666 |
$63K |
| L3650 |
So 8 abd restraint pre ots |
2,247 |
2,039 |
$61K |
| L3675 |
So vest canvas/web pre ots |
653 |
606 |
$57K |
| L3170 |
Foot plas heel stabi pre ots |
2,487 |
2,072 |
$50K |
| L3762 |
Eo rigid w/o joints pre ots |
754 |
585 |
$44K |
| E0135 |
Walker folding adjust/fixed |
1,370 |
1,208 |
$42K |
| L1660 |
Ho abduction static plastic |
311 |
288 |
$28K |
| L0172 |
Cerv col sr foam 2pc pre ots |
371 |
339 |
$23K |
| L0120 |
Cerv flex n/adj foam pre ots |
1,696 |
1,554 |
$21K |
| L1845 |
Ko double upright pre cst |
51 |
40 |
$20K |
| E0100 |
Cane adjust/fixed with tip |
1,520 |
1,448 |
$18K |
| L1930 |
Afo plastic |
144 |
105 |
$14K |
| A4570 |
Splint |
1,449 |
1,266 |
$13K |
| L4386 |
Non-pneum walk boot pre cst |
137 |
131 |
$12K |
| E0218 |
Fluid circ cold pad w pump |
171 |
161 |
$12K |
| L0621 |
Sio flex pelvic/sacr pre ots |
247 |
225 |
$10K |
| 99070 |
|
264 |
93 |
$10K |
| L1821 |
Ko elas w/ condyle pads otf |
159 |
146 |
$8K |
| L3332 |
Shoe lifts tapered to one-ha |
246 |
226 |
$7K |
| L3960 |
Sewho airplan desig abdu pos |
13 |
13 |
$6K |
| L3760 |
Eo adj jt prefab custom fit |
31 |
28 |
$5K |
| L0150 |
Cerv semi-rig adj molded chn |
85 |
77 |
$3K |
| A9270 |
Non-covered item or service |
2,033 |
1,376 |
$3K |
| L2999 |
Lower extremity orthosis nos |
240 |
205 |
$3K |
| L3923 |
Hfo without joints pre cst |
105 |
70 |
$2K |
| L3999 |
Upper limb orthosis nos |
74 |
69 |
$2K |
| L1906 |
Afo multilig ank sup pre ots |
14 |
14 |
$952.54 |
| L4396 |
Static or dynami afo pre cst |
14 |
13 |
$815.00 |
| L0641 |
Lo rig pos pnl l1-l5 pre ots |
30 |
28 |
$734.61 |
| S9999 |
Sales tax |
156 |
87 |
$459.53 |
| A6530 |
Compression stocking bk18-30 |
23 |
13 |
$168.33 |