| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
8,795 |
8,554 |
$1.07M |
| L3809 |
Whfo w/o joints pre ots |
4,368 |
4,222 |
$478K |
| L3670 |
So acro/clav can web pre ots |
9,599 |
9,171 |
$472K |
| L1833 |
Ko adj jnt pos r sup pre ots |
1,548 |
1,490 |
$392K |
| E0114 |
Crutch underarm pair no wood |
11,111 |
10,710 |
$261K |
| L4387 |
Non-pneum walk boot pre ots |
3,053 |
2,970 |
$258K |
| L3908 |
Who cock-up nonmolde pre ots |
9,387 |
8,953 |
$254K |
| L1820 |
Ko elas w/ condyle pads & jo |
2,796 |
2,582 |
$185K |
| L1902 |
Afo ankle gauntlet pre ots |
2,921 |
2,770 |
$129K |
| L3260 |
Ambulatory surgical boot eac |
6,192 |
5,635 |
$117K |
| L1830 |
Ko immob canvas long pre ots |
3,238 |
3,035 |
$116K |
| L4350 |
Ankle control ortho pre ots |
2,261 |
2,216 |
$91K |
| E0143 |
Walker folding wheeled w/o s |
1,625 |
1,567 |
$70K |
| L0625 |
Lo flex l1-below l5 pre ots |
1,306 |
1,257 |
$41K |
| A4467 |
Belt strap sleev grmnt cover |
828 |
691 |
$24K |
| L3982 |
Upper ext fx orthosis rad/ul |
63 |
63 |
$13K |
| A4565 |
Slings |
1,125 |
1,068 |
$6K |
| K0006 |
Heavy duty wheelchair |
90 |
55 |
$5K |
| K0001 |
Standard wheelchair |
149 |
113 |
$4K |
| L0172 |
Cerv col sr foam 2pc pre ots |
47 |
44 |
$2K |
| E0163 |
Commode chair with fixed arm |
12 |
12 |
$488.56 |
| A9270 |
Non-covered item or service |
102 |
96 |
$0.00 |