| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
278 |
218 |
$32K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
15 |
12 |
$10K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
103 |
88 |
$7K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
15 |
12 |
$3K |
| L2220 |
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
15 |
12 |
$2K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
13 |
13 |
$2K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
12 |
12 |
$1K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
22 |
12 |
$966.29 |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
14 |
12 |
$794.05 |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
15 |
13 |
$662.76 |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
14 |
12 |
$413.60 |