| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Ft insert ucb berkeley shell |
4,110 |
2,074 |
$916K |
| L4361 |
Pneuma/vac walk boot pre ots |
555 |
554 |
$116K |
| L2275 |
Plastic mod low ext pad/line |
481 |
291 |
$31K |
| L2999 |
Lower extremity orthosis nos |
594 |
316 |
$30K |
| L2820 |
Soft interface below knee se |
395 |
239 |
$25K |
| L1820 |
Ko elas w/ condyle pads & jo |
228 |
206 |
$15K |
| L1906 |
Afo multilig ank sup pre ots |
54 |
49 |
$5K |
| A5500 |
Diab shoe for density insert |
353 |
192 |
$4K |
| L3908 |
Who cock-up nonmolde pre ots |
92 |
66 |
$3K |
| L4397 |
Static or dynami afo pre ots |
14 |
12 |
$2K |
| L3260 |
Ambulatory surgical boot eac |
15 |
14 |
$1K |
| A5513 |
Multi den insert custom mold |
16 |
16 |
$939.58 |
| A5512 |
Multi den insert direct form |
14 |
14 |
$736.44 |
| A5514 |
Mult den insert dir carv/cam |
25 |
13 |
$622.78 |