| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1833 |
Ko adj jnt pos r sup pre ots |
903 |
811 |
$414K |
| L4361 |
Pneuma/vac walk boot pre ots |
2,298 |
2,099 |
$395K |
| L1846 |
Ko w adj flex/ext rotat mold |
332 |
283 |
$291K |
| L3809 |
Whfo w/o joints pre ots |
1,169 |
1,072 |
$167K |
| L2425 |
Knee disc/dial lock/adj flex |
245 |
204 |
$51K |
| L2755 |
Carbon graphite lamination |
332 |
286 |
$46K |
| L1902 |
Afo ankle gauntlet pre ots |
965 |
892 |
$45K |
| L3984 |
Upper ext fx orthosis wrist |
119 |
112 |
$27K |
| L2830 |
Soft interface above knee se |
236 |
198 |
$16K |
| L1812 |
Ko elastic w/joints pre ots |
185 |
172 |
$15K |
| L3908 |
Who cock-up nonmolde pre ots |
459 |
438 |
$15K |
| L2397 |
Suspension sleeve lower ext |
202 |
177 |
$15K |
| L2820 |
Soft interface below knee se |
243 |
199 |
$14K |
| L3960 |
Sewho airplan desig abdu pos |
26 |
26 |
$13K |
| E0114 |
Crutch underarm pair no wood |
241 |
227 |
$11K |
| L2795 |
Knee control full kneecap |
147 |
137 |
$7K |
| K0823 |
Pwc gp 2 std cap chair |
234 |
225 |
$6K |
| E0261 |
Hosp bed semi-electr w/o mat |
612 |
594 |
$5K |
| E0973 |
W/ch access det adj armrest |
1,465 |
1,417 |
$4K |
| L3660 |
So 8 ab rstr can/web pre ots |
57 |
54 |
$3K |
| E0971 |
Wheelchair anti-tipping devi |
1,515 |
1,463 |
$2K |
| K0003 |
Lightweight wheelchair |
405 |
397 |
$2K |
| K0001 |
Standard wheelchair |
445 |
430 |
$2K |
| A5500 |
Diab shoe for density insert |
314 |
222 |
$1K |
| L1820 |
Ko elas w/ condyle pads & jo |
12 |
12 |
$967.54 |
| K0195 |
Elevating whlchair leg rests |
198 |
193 |
$442.82 |
| E0165 |
Commode chair with detacharm |
77 |
75 |
$428.17 |
| A5512 |
Multi den insert direct form |
312 |
222 |
$12.88 |