| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
1,623 |
1,501 |
$213K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
2,359 |
2,153 |
$110K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
2,428 |
2,275 |
$58K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,150 |
999 |
$28K |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
1,496 |
1,388 |
$28K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,151 |
1,046 |
$24K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
449 |
419 |
$18K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
135 |
121 |
$16K |
| K0001 |
Standard wheelchair |
1,989 |
1,786 |
$14K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
41 |
40 |
$5K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
829 |
735 |
$3K |
| K0003 |
Lightweight wheelchair |
262 |
244 |
$2K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
25 |
24 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
96 |
81 |
$1K |
| E0570 |
Nebulizer, with compressor |
50 |
48 |
$1K |
| E0163 |
Commode chair, mobile or stationary, with fixed arms |
15 |
13 |
$273.54 |