| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
5,538 |
3,397 |
$595K |
| L3670 |
So acro/clav can web pre ots |
8,678 |
5,102 |
$298K |
| L3809 |
Whfo w/o joints pre ots |
2,831 |
1,704 |
$243K |
| E0114 |
Crutch underarm pair no wood |
8,772 |
5,253 |
$189K |
| L3908 |
Who cock-up nonmolde pre ots |
5,669 |
3,092 |
$94K |
| L1830 |
Ko immob canvas long pre ots |
2,576 |
1,551 |
$73K |
| L4350 |
Ankle control ortho pre ots |
817 |
484 |
$26K |
| L1902 |
Afo ankle gauntlet pre ots |
480 |
285 |
$17K |
| L1820 |
Ko elas w/ condyle pads & jo |
150 |
78 |
$7K |
| L3260 |
Ambulatory surgical boot eac |
607 |
357 |
$4K |
| L4387 |
Non-pneum walk boot pre ots |
13 |
12 |
$302.68 |
| A4565 |
Slings |
65 |
41 |
$0.00 |
| A4467 |
Belt strap sleev grmnt cover |
560 |
458 |
$0.00 |