| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4360 |
Pneumat walking boot pre cst |
5,951 |
5,767 |
$679K |
| L4361 |
Pneuma/vac walk boot pre ots |
4,651 |
4,132 |
$652K |
| L3670 |
So acro/clav can web pre ots |
9,496 |
9,005 |
$452K |
| L3807 |
Whfo w/o joints pre cst |
3,794 |
3,606 |
$387K |
| E0114 |
Crutch underarm pair no wood |
14,510 |
13,902 |
$348K |
| L3908 |
Who cock-up nonmolde pre ots |
12,473 |
10,954 |
$347K |
| L0633 |
Lso sc r pos/lat pnl pre cst |
1,540 |
1,489 |
$272K |
| L3809 |
Whfo w/o joints pre ots |
2,015 |
1,842 |
$256K |
| L4350 |
Ankle control ortho pre ots |
5,091 |
4,802 |
$227K |
| E0466 |
Home vent non-invasive inter |
666 |
559 |
$210K |
| L1832 |
Ko adj jnt pos r sup pre cst |
673 |
636 |
$204K |
| L1820 |
Ko elas w/ condyle pads & jo |
2,409 |
2,173 |
$128K |
| L1810 |
Ko elastic with joints |
2,642 |
2,427 |
$124K |
| L1830 |
Ko immob canvas long pre ots |
2,853 |
2,670 |
$122K |
| L1902 |
Afo ankle gauntlet pre ots |
3,090 |
2,900 |
$95K |
| E0601 |
Cont airway pressure device |
2,106 |
1,950 |
$75K |
| E0470 |
Rad w/o backup non-inv intfc |
688 |
600 |
$60K |
| L2795 |
Knee control full kneecap |
2,164 |
1,903 |
$57K |
| L0639 |
Lso s/c shell/panel prefab |
110 |
107 |
$51K |
| E1390 |
Oxygen concentrator |
970 |
894 |
$45K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
388 |
382 |
$38K |
| L3660 |
So 8 ab rstr can/web pre ots |
630 |
601 |
$31K |
| E0562 |
Humidifier heated used w pap |
1,436 |
1,307 |
$30K |
| L3650 |
So 8 abd restraint pre ots |
940 |
910 |
$29K |
| A7031 |
Replacement facemask interfa |
1,140 |
1,037 |
$29K |
| L1833 |
Ko adj jnt pos r sup pre ots |
93 |
83 |
$27K |
| L1812 |
Ko elastic w/joints pre ots |
467 |
397 |
$26K |
| A4604 |
Tubing with heating element |
710 |
674 |
$21K |
| L0649 |
Lso sc r pos/lat pnl pre ots |
116 |
115 |
$17K |
| L3260 |
Ambulatory surgical boot eac |
2,358 |
2,196 |
$15K |
| L4387 |
Non-pneum walk boot pre ots |
172 |
151 |
$15K |
| A7032 |
Replacement nasal cushion |
457 |
411 |
$10K |
| L2810 |
Knee control condylar pad |
180 |
160 |
$9K |
| A7038 |
Pos airway pressure filter |
2,628 |
2,394 |
$8K |
| L1906 |
Afo multilig ank sup pre ots |
147 |
130 |
$6K |
| E0603 |
Electric breast pump |
45 |
45 |
$6K |
| E1392 |
Portable oxygen concentrator |
339 |
328 |
$5K |
| A7030 |
Cpap full face mask |
77 |
72 |
$5K |
| E0570 |
Nebulizer with compression |
62 |
53 |
$5K |
| A7035 |
Pos airway press headgear |
289 |
276 |
$4K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
25 |
24 |
$3K |
| E0431 |
Portable gaseous 02 |
157 |
146 |
$2K |
| A7033 |
Replacement nasal pillows |
156 |
145 |
$2K |
| A7034 |
Nasal application device |
18 |
15 |
$710.10 |
| L4396 |
Static or dynami afo pre cst |
13 |
13 |
$696.90 |
| A7037 |
Pos airway pressure tubing |
69 |
60 |
$576.80 |
| L2830 |
Soft interface above knee se |
12 |
12 |
$446.16 |
| L2820 |
Soft interface below knee se |
12 |
12 |
$412.44 |
| A7046 |
Repl water chamber, pap dev |
52 |
52 |
$375.94 |
| A7000 |
Disposable canister for pump |
12 |
12 |
$90.00 |