| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
2,877 |
2,736 |
$512K |
| E0143 |
Walker folding wheeled w/o s |
2,180 |
2,033 |
$78K |
| A4670 |
Automatic bp monitor, dial |
1,773 |
1,659 |
$76K |
| L3807 |
Whfo w/o joints pre cst |
574 |
505 |
$43K |
| A5500 |
Diab shoe for density insert |
1,403 |
653 |
$33K |
| E0114 |
Crutch underarm pair no wood |
1,276 |
1,201 |
$26K |
| E0245 |
Tub stool or bench |
651 |
611 |
$18K |
| L1906 |
Afo multilig ank sup pre ots |
255 |
232 |
$14K |
| L3000 |
Ft insert ucb berkeley shell |
78 |
39 |
$9K |
| A5514 |
Mult den insert dir carv/cam |
364 |
173 |
$9K |
| L1830 |
Ko immob canvas long pre ots |
92 |
77 |
$3K |
| L4360 |
Pneumat walking boot pre cst |
12 |
12 |
$2K |
| L3420 |
Full sole/heel wedge btween |
47 |
43 |
$2K |
| L3670 |
So acro/clav can web pre ots |
26 |
25 |
$1K |
| E0730 |
Tens four lead |
26 |
26 |
$1K |
| L4386 |
Non-pneum walk boot pre cst |
14 |
14 |
$1K |
| A5513 |
Multi den insert custom mold |
58 |
30 |
$1K |
| A4663 |
Dialysis blood pressure cuff |
1,114 |
1,036 |
$78.35 |