| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Molded inner boot |
3,479 |
1,751 |
$745K |
| L2275 |
Plastic mod low ext pad/line |
6,095 |
3,178 |
$246K |
| L1904 |
Afo molded ankle gauntlet |
824 |
400 |
$182K |
| L2270 |
Varus/valgus strap padded/li |
4,729 |
2,476 |
$87K |
| L1970 |
Afo plastic molded w/ankle j |
149 |
83 |
$79K |
| L1200 |
Furnsh initial orthosis only |
74 |
70 |
$58K |
| L1960 |
Afo pos solid ank plastic mo |
141 |
74 |
$48K |
| L2820 |
Soft interface below knee se |
2,034 |
1,100 |
$40K |
| L4205 |
Ortho dvc repair per 15 min |
529 |
447 |
$20K |
| L3202 |
Oxford w/ supinat/pronator c |
775 |
422 |
$15K |
| L3906 |
Who w/o joints cf |
55 |
41 |
$14K |
| L2840 |
Tibial length sock fx or equ |
911 |
526 |
$14K |
| L2340 |
Pre-tibial shell molded to p |
28 |
17 |
$4K |
| L1260 |
Anterior thoracic derotation |
80 |
77 |
$2K |
| L1210 |
Lateral thoracic extension |
80 |
77 |
$2K |
| L1270 |
Abdominal pad |
73 |
70 |
$2K |
| L1240 |
Lumbar derotation pad |
73 |
70 |
$2K |
| L1280 |
Rib gusset (elastic) each |
71 |
69 |
$2K |
| L1290 |
Lateral trochanteric pad |
73 |
70 |
$2K |
| L1250 |
Anterior asis pad |
73 |
70 |
$1K |
| L2200 |
Limited ankle motion ea jnt |
63 |
37 |
$975.84 |