| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Ft insert ucb berkeley shell |
10,174 |
5,173 |
$1.65M |
| L2112 |
Afo tibial fracture soft |
1,998 |
1,982 |
$451K |
| L2114 |
Afo tib fx semi-rigid |
1,166 |
1,166 |
$285K |
| L2275 |
Plastic mod low ext pad/line |
3,283 |
1,722 |
$173K |
| L3215 |
Orthopedic ftwear ladies oxf |
3,691 |
1,893 |
$171K |
| L3219 |
Orthopedic mens shoes oxford |
3,057 |
1,555 |
$163K |
| L3915 |
Who nontorsion jnts pre cst |
637 |
420 |
$133K |
| L0637 |
Lso sc r ant/pos pnl pre cst |
412 |
409 |
$121K |
| L3809 |
Whfo w/o joints pre ots |
1,240 |
1,163 |
$117K |
| L3202 |
Oxford w/ supinat/pronator c |
4,045 |
2,037 |
$91K |
| L3908 |
Who cock-up nonmolde pre ots |
2,937 |
2,875 |
$88K |
| L1832 |
Ko adj jnt pos r sup pre cst |
250 |
203 |
$70K |
| E0570 |
Nebulizer with compression |
1,041 |
1,030 |
$70K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
224 |
222 |
$64K |
| L3916 |
Who nontorsion jnts pre ots |
355 |
266 |
$58K |
| L3030 |
Foot arch support remov prem |
1,050 |
534 |
$46K |
| L1833 |
Ko adj jnt pos r sup pre ots |
233 |
178 |
$45K |
| A7005 |
Nondisposable nebulizer set |
1,413 |
1,387 |
$19K |
| E0114 |
Crutch underarm pair no wood |
973 |
969 |
$19K |
| L4361 |
Pneuma/vac walk boot pre ots |
137 |
136 |
$16K |
| A6540 |
Gc stocking waistlngth 30-40 |
95 |
91 |
$14K |
| L0180 |
Cer post col occ/man sup adj |
148 |
148 |
$14K |
| L3260 |
Ambulatory surgical boot eac |
1,079 |
1,073 |
$13K |
| L3670 |
So acro/clav can web pre ots |
228 |
220 |
$13K |
| L1902 |
Afo ankle gauntlet pre ots |
408 |
395 |
$13K |
| A5513 |
Multi den insert custom mold |
508 |
254 |
$12K |
| A5500 |
Diab shoe for density insert |
566 |
288 |
$11K |
| A6530 |
Compression stocking bk18-30 |
248 |
130 |
$10K |
| L3660 |
So 8 ab rstr can/web pre ots |
296 |
293 |
$9K |
| L1906 |
Afo multilig ank sup pre ots |
191 |
187 |
$9K |
| L1971 |
Afo w/ankle joint, prefab |
49 |
40 |
$9K |
| L3203 |
Oxford w/ supinator/pronator |
372 |
189 |
$8K |
| L3020 |
Foot longitud/metatarsal sup |
81 |
41 |
$7K |
| L1820 |
Ko elas w/ condyle pads & jo |
96 |
77 |
$5K |
| E0650 |
Pneuma compresor non-segment |
59 |
59 |
$5K |
| L3010 |
Foot longitudinal arch suppo |
55 |
28 |
$4K |
| L3960 |
Sewho airplan desig abdu pos |
12 |
12 |
$3K |
| L3050 |
Foot arch supp premold metat |
78 |
48 |
$2K |
| E0603 |
Electric breast pump |
13 |
12 |
$2K |
| L2397 |
Suspension sleeve lower ext |
94 |
61 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
1,388 |
1,341 |
$1K |
| K1005 |
Disp col sto bag breast milk |
12 |
12 |
$462.00 |
| A7013 |
Disposable compressor filter |
1,329 |
1,289 |
$134.79 |