| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1960 |
Afo pos solid ank plastic mo |
2,725 |
2,269 |
$1.65M |
| L1970 |
Afo plastic molded w/ankle j |
1,749 |
1,364 |
$1.13M |
| L2275 |
Plastic mod low ext pad/line |
7,408 |
6,038 |
$1.02M |
| L2280 |
Molded inner boot |
1,725 |
1,384 |
$909K |
| L2820 |
Soft interface below knee se |
7,299 |
5,921 |
$690K |
| L3000 |
Ft insert ucb berkeley shell |
852 |
631 |
$254K |
| L2999 |
Lower extremity orthosis nos |
2,321 |
1,393 |
$214K |
| L2755 |
Carbon graphite lamination |
1,575 |
1,310 |
$190K |
| L2210 |
Dorsiflexion assist each joi |
1,379 |
1,081 |
$159K |
| A6533 |
Gc stocking thighlngth 18-30 |
1,832 |
1,387 |
$143K |
| A5500 |
Diab shoe for density insert |
3,852 |
2,121 |
$140K |
| L2232 |
Rocker bottom, contact afo |
1,345 |
1,119 |
$136K |
| A6530 |
Compression stocking bk18-30 |
2,332 |
1,782 |
$135K |
| L2220 |
Dorsi & plantar flex ass/res |
1,332 |
1,054 |
$117K |
| S1040 |
Cranial remolding orthosis |
54 |
51 |
$104K |
| L2768 |
Ortho sidebar disconnect |
743 |
594 |
$103K |
| L5679 |
Socket insert w/o lock mech |
166 |
134 |
$95K |
| L1930 |
Afo plastic |
269 |
217 |
$85K |
| L1907 |
Afo supramalleolar custom |
140 |
123 |
$83K |
| L3908 |
Who cock-up nonmolde pre ots |
1,409 |
1,161 |
$71K |
| L3540 |
Ortho shoe add full sole |
1,098 |
915 |
$58K |
| L5637 |
Below knee total contact |
286 |
253 |
$57K |
| L8420 |
Prosthetic sock multi ply bk |
386 |
337 |
$54K |
| L1820 |
Ko elas w/ condyle pads & jo |
545 |
468 |
$46K |
| L2270 |
Varus/valgus strap padded/li |
868 |
705 |
$45K |
| L5940 |
Endo bk ultra-light material |
141 |
127 |
$44K |
| L5629 |
Below knee acrylic socket |
232 |
210 |
$42K |
| A5513 |
Multi den insert custom mold |
1,646 |
1,137 |
$41K |
| L4361 |
Pneuma/vac walk boot pre ots |
250 |
236 |
$35K |
| L5673 |
Socket insert w lock mech |
48 |
43 |
$34K |
| L1200 |
Furnsh initial orthosis only |
33 |
28 |
$33K |
| L5620 |
Test socket below knee |
142 |
128 |
$28K |
| L3010 |
Foot longitudinal arch suppo |
206 |
126 |
$26K |
| L3460 |
Shoe heel new rubber standar |
855 |
666 |
$25K |
| L3350 |
Shoe heel wedge |
910 |
757 |
$22K |
| L8400 |
Sheath below knee |
243 |
208 |
$20K |
| L3310 |
Shoe lift elev heel/sole neo |
142 |
135 |
$18K |
| L5685 |
Below knee sus/seal sleeve |
115 |
98 |
$14K |
| L2861 |
Torsion mechanism knee/ankle |
33 |
26 |
$12K |
| E0114 |
Crutch underarm pair no wood |
239 |
223 |
$12K |
| L8470 |
Pros sock single ply bk |
379 |
340 |
$11K |
| A6549 |
Grad com garm noc day use |
13 |
13 |
$11K |
| A5512 |
Multi den insert direct form |
504 |
217 |
$10K |
| L1940 |
Afo molded to patient plasti |
14 |
13 |
$9K |
| L5671 |
Bk/ak locking mechanism |
26 |
25 |
$8K |
| L2340 |
Pre-tibial shell molded to p |
16 |
14 |
$8K |
| L2840 |
Tibial length sock fx or equ |
198 |
148 |
$7K |
| L2830 |
Soft interface above knee se |
82 |
67 |
$7K |
| A5514 |
Mult den insert dir carv/cam |
215 |
168 |
$7K |
| L3809 |
Whfo w/o joints pre ots |
61 |
48 |
$7K |
| A6539 |
Gc stocking waistlngth 18-30 |
47 |
36 |
$5K |
| L5647 |
Below knee suction socket |
18 |
14 |
$4K |
| L2810 |
Knee control condylar pad |
34 |
24 |
$3K |
| L3070 |
Arch suprt att to sho longit |
153 |
116 |
$3K |
| L5910 |
Endo below knee alignable sy |
13 |
13 |
$3K |
| L8030 |
Breast prosthes w/o adhesive |
15 |
14 |
$3K |
| L3660 |
So 8 ab rstr can/web pre ots |
13 |
13 |
$1K |
| L8000 |
Mastectomy bra |
33 |
27 |
$1K |
| L3390 |
Shoe outflare wedge |
25 |
14 |
$475.71 |
| L3260 |
Ambulatory surgical boot eac |
30 |
24 |
$354.82 |
| A4565 |
Slings |
13 |
13 |
$111.41 |