| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4360 |
Pneumat walking boot pre cst |
1,787 |
1,602 |
$218K |
| L3020 |
Foot longitud/metatarsal sup |
2,007 |
951 |
$156K |
| A5500 |
Diab shoe for density insert |
4,092 |
1,969 |
$97K |
| L3908 |
Who cock-up nonmolde pre ots |
2,793 |
2,145 |
$89K |
| L4361 |
Pneuma/vac walk boot pre ots |
699 |
652 |
$79K |
| L1820 |
Ko elas w/ condyle pads & jo |
1,017 |
866 |
$68K |
| L1970 |
Afo plastic molded w/ankle j |
269 |
197 |
$61K |
| A5514 |
Mult den insert dir carv/cam |
2,452 |
1,185 |
$50K |
| L3809 |
Whfo w/o joints pre ots |
428 |
382 |
$49K |
| L1902 |
Afo ankle gauntlet pre ots |
1,057 |
964 |
$37K |
| L3807 |
Whfo w/o joints pre cst |
297 |
275 |
$33K |
| L2820 |
Soft interface below knee se |
988 |
708 |
$26K |
| A5513 |
Multi den insert custom mold |
905 |
531 |
$20K |
| L8420 |
Prosthetic sock multi ply bk |
82 |
65 |
$2K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
14 |
13 |
$1K |
| L2999 |
Lower extremity orthosis nos |
16 |
15 |
$727.72 |
| L4350 |
Ankle control ortho pre ots |
14 |
12 |
$680.12 |
| L5685 |
Below knee sus/seal sleeve |
16 |
13 |
$573.99 |