| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1833 |
Ko adj jnt pos r sup pre ots |
1,049 |
508 |
$187K |
| L0648 |
Lso sag r an/pos pnl pre ots |
741 |
532 |
$179K |
| L4361 |
Pneuma/vac walk boot pre ots |
1,014 |
960 |
$167K |
| A4595 |
Tens suppl 2 lead per month |
4,884 |
4,351 |
$140K |
| L3809 |
Whfo w/o joints pre ots |
1,880 |
1,359 |
$125K |
| E0730 |
Tens four lead |
777 |
702 |
$120K |
| E0745 |
Neuromuscular stim for shock |
700 |
510 |
$115K |
| A5500 |
Diab shoe for density insert |
6,024 |
3,766 |
$101K |
| E0570 |
Nebulizer with compression |
1,772 |
1,707 |
$93K |
| L3960 |
Sewho airplan desig abdu pos |
383 |
257 |
$93K |
| L1971 |
Afo w/ankle joint, prefab |
511 |
265 |
$86K |
| E0731 |
Conductive garment for tens/ |
530 |
456 |
$80K |
| A5513 |
Multi den insert custom mold |
1,662 |
1,286 |
$69K |
| L3908 |
Who cock-up nonmolde pre ots |
868 |
808 |
$34K |
| A5514 |
Mult den insert dir carv/cam |
1,658 |
787 |
$30K |
| L0174 |
Cerv sr 2pc thor ext pre ots |
477 |
350 |
$29K |
| L2397 |
Suspension sleeve lower ext |
913 |
408 |
$22K |
| L0650 |
Lso sc r ant/pos pnl pre ots |
48 |
47 |
$21K |
| A5512 |
Multi den insert direct form |
1,193 |
682 |
$17K |
| K0903 |
Mult den insert dir carv/cam |
644 |
560 |
$14K |
| A6531 |
Compress stking bk30-40 surg |
350 |
258 |
$14K |
| A7005 |
Nondisposable nebulizer set |
1,712 |
1,651 |
$13K |
| L1660 |
Ho abduction static plastic |
170 |
113 |
$12K |
| L3710 |
Eo elas w/metal jnts pre ots |
272 |
162 |
$10K |
| L4387 |
Non-pneum walk boot pre ots |
58 |
56 |
$6K |
| L1831 |
Knee orth pos locking joint |
121 |
76 |
$5K |
| A4557 |
Lead wires, pair |
1,079 |
813 |
$5K |
| L1902 |
Afo ankle gauntlet pre ots |
133 |
117 |
$4K |
| L3807 |
Whfo w/o joints pre cst |
24 |
24 |
$3K |
| L4360 |
Pneumat walking boot pre cst |
12 |
12 |
$2K |
| A7015 |
Aerosol mask used w nebulize |
1,710 |
1,650 |
$2K |
| L3761 |
Eo, adj lock joint prefab ot |
18 |
14 |
$854.92 |
| E0114 |
Crutch underarm pair no wood |
20 |
17 |
$505.94 |