| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
63 |
52 |
$17K |
| E1399 |
Durable medical equipment, miscellaneous |
64 |
52 |
$15K |
| E0673 |
Segmental gradient pressure pneumatic appliance, half leg |
62 |
26 |
$4K |
| E0236 |
Pump for water circulating pad |
243 |
211 |
$3K |
| E0675 |
Pneumatic compression device, high pressure, rapid inflation/deflation cycle, for arterial insufficiency (unilateral or bilateral system) |
47 |
39 |
$3K |
| E0650 |
Pneumatic compressor, non-segmental home model |
106 |
88 |
$2K |
| E0249 |
Pad for water circulating heat unit, for replacement only |
46 |
38 |
$2K |
| E0218 |
Fluid circulating cold pad with pump, any type |
47 |
41 |
$1K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
16 |
16 |
$0.00 |