| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4360 |
Pneumat walking boot pre cst |
1,119 |
869 |
$192K |
| L3908 |
Who cock-up nonmolde pre ots |
986 |
765 |
$32K |
| L3807 |
Whfo w/o joints pre cst |
119 |
94 |
$16K |
| L1902 |
Afo ankle gauntlet pre ots |
298 |
212 |
$12K |
| L1820 |
Ko elas w/ condyle pads & jo |
160 |
107 |
$11K |
| L4361 |
Pneuma/vac walk boot pre ots |
12 |
12 |
$2K |
| E0570 |
Nebulizer with compression |
15 |
12 |
$2K |
| L4386 |
Non-pneum walk boot pre cst |
15 |
12 |
$2K |
| E0114 |
Crutch underarm pair no wood |
20 |
12 |
$573.44 |
| A7003 |
Nebulizer administration set |
15 |
12 |
$39.00 |
| A7015 |
Aerosol mask used w nebulize |
15 |
12 |
$27.45 |