| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3660 |
So 8 ab rstr can/web pre ots |
3,383 |
3,351 |
$17K |
| L4361 |
Pneuma/vac walk boot pre ots |
903 |
901 |
$15K |
| L3809 |
Whfo w/o joints pre ots |
530 |
519 |
$6K |
| L1830 |
Ko immob canvas long pre ots |
703 |
701 |
$5K |
| L3908 |
Who cock-up nonmolde pre ots |
949 |
905 |
$5K |
| E0114 |
Crutch underarm pair no wood |
443 |
442 |
$3K |
| L4350 |
Ankle control ortho pre ots |
228 |
228 |
$1K |
| L1820 |
Ko elas w/ condyle pads & jo |
103 |
101 |
$1K |
| L1833 |
Ko adj jnt pos r sup pre ots |
54 |
54 |
$921.78 |
| L3260 |
Ambulatory surgical boot eac |
158 |
155 |
$523.96 |
| L0172 |
Cerv col sr foam 2pc pre ots |
51 |
51 |
$245.19 |