| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
1,623 |
1,501 |
$213K |
| L3670 |
So acro/clav can web pre ots |
2,359 |
2,153 |
$110K |
| E0114 |
Crutch underarm pair no wood |
2,428 |
2,275 |
$58K |
| L3908 |
Who cock-up nonmolde pre ots |
1,150 |
999 |
$28K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,496 |
1,388 |
$28K |
| E1390 |
Oxygen concentrator |
1,151 |
1,046 |
$24K |
| L1830 |
Ko immob canvas long pre ots |
449 |
419 |
$18K |
| L3809 |
Whfo w/o joints pre ots |
135 |
121 |
$16K |
| K0001 |
Standard wheelchair |
1,989 |
1,786 |
$14K |
| L4360 |
Pneumat walking boot pre cst |
41 |
40 |
$5K |
| E0431 |
Portable gaseous 02 |
829 |
735 |
$3K |
| K0003 |
Lightweight wheelchair |
262 |
244 |
$2K |
| L1820 |
Ko elas w/ condyle pads & jo |
25 |
24 |
$1K |
| E0143 |
Walker folding wheeled w/o s |
96 |
81 |
$1K |
| E0570 |
Nebulizer with compression |
50 |
48 |
$1K |
| E0163 |
Commode chair with fixed arm |
15 |
13 |
$273.54 |