| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
1,154 |
1,065 |
$208K |
| L3670 |
So acro/clav can web pre ots |
1,398 |
1,290 |
$111K |
| L3809 |
Whfo w/o joints pre ots |
685 |
617 |
$91K |
| L3908 |
Who cock-up nonmolde pre ots |
2,037 |
1,711 |
$78K |
| E0114 |
Crutch underarm pair no wood |
1,515 |
1,402 |
$49K |
| L1833 |
Ko adj jnt pos r sup pre ots |
93 |
88 |
$41K |
| L1902 |
Afo ankle gauntlet pre ots |
179 |
161 |
$9K |
| L3260 |
Ambulatory surgical boot eac |
563 |
491 |
$8K |
| L1812 |
Ko elastic w/joints pre ots |
117 |
101 |
$8K |
| L4350 |
Ankle control ortho pre ots |
143 |
125 |
$7K |
| L2114 |
Afo tib fx semi-rigid |
17 |
12 |
$5K |
| L0621 |
Sio flex pelvic/sacr pre ots |
14 |
12 |
$995.17 |
| L2795 |
Knee control full kneecap |
14 |
12 |
$788.58 |