| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6539 |
Gc stocking waistlngth 18-30 |
19,120 |
17,126 |
$2.45M |
| E0603 |
Electric breast pump |
10,638 |
9,680 |
$1.40M |
| A6540 |
Gc stocking waistlngth 30-40 |
7,748 |
7,183 |
$1.19M |
| A6530 |
Compression stocking bk18-30 |
12,714 |
5,939 |
$374K |
| L3001 |
Foot insert remov molded spe |
2,878 |
1,439 |
$223K |
| L0621 |
Sio flex pelvic/sacr pre ots |
2,898 |
2,836 |
$143K |
| A4510 |
Full length surg stocking |
3,157 |
1,437 |
$133K |
| A4287 |
Disp col sto bag breast milk |
3,205 |
3,188 |
$126K |
| L8310 |
Truss double w/ standard pad |
1,652 |
1,607 |
$114K |
| A6533 |
Gc stocking thighlngth 18-30 |
2,053 |
967 |
$77K |
| L1930 |
Afo plastic |
437 |
432 |
$56K |
| E0602 |
Manual breast pump |
1,836 |
1,814 |
$56K |
| K1005 |
Disp col sto bag breast milk |
894 |
883 |
$35K |
| A6536 |
Gc stocking full lngth 18-30 |
744 |
359 |
$34K |
| L0625 |
Lo flex l1-below l5 pre ots |
995 |
984 |
$29K |
| A6531 |
Compress stking bk30-40 surg |
1,109 |
530 |
$28K |
| L3000 |
Ft insert ucb berkeley shell |
150 |
75 |
$28K |
| L1620 |
Ho flex pavlik harns pre cst |
479 |
473 |
$27K |
| L3060 |
Foot arch supp longitud/meta |
385 |
192 |
$13K |
| L3908 |
Who cock-up nonmolde pre ots |
374 |
287 |
$13K |
| A6534 |
Gc stocking thighlngth 30-40 |
266 |
126 |
$11K |
| S8270 |
Enuresis alarm |
26 |
26 |
$5K |
| A6552 |
Grad com stocking bk 30-40 |
137 |
68 |
$4K |
| E0570 |
Nebulizer with compression |
20 |
20 |
$1K |
| L3332 |
Shoe lifts tapered to one-ha |
36 |
18 |
$1K |
| L1902 |
Afo ankle gauntlet pre ots |
12 |
12 |
$492.50 |
| L3260 |
Ambulatory surgical boot eac |
13 |
13 |
$228.06 |