| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2275 |
Plastic mod low ext pad/line |
278 |
218 |
$32K |
| L1970 |
Afo plastic molded w/ankle j |
15 |
12 |
$10K |
| L2820 |
Soft interface below knee se |
103 |
88 |
$7K |
| L3010 |
Foot longitudinal arch suppo |
15 |
12 |
$3K |
| L2220 |
Dorsi & plantar flex ass/res |
15 |
12 |
$2K |
| L4361 |
Pneuma/vac walk boot pre ots |
13 |
13 |
$2K |
| L4387 |
Non-pneum walk boot pre ots |
12 |
12 |
$1K |
| A5500 |
Diab shoe for density insert |
22 |
12 |
$966.29 |
| L2270 |
Varus/valgus strap padded/li |
14 |
12 |
$794.05 |
| L3908 |
Who cock-up nonmolde pre ots |
15 |
13 |
$662.76 |
| L3202 |
Oxford w/ supinat/pronator c |
14 |
12 |
$413.60 |