| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1930 |
Afo plastic |
869 |
449 |
$170K |
| L3002 |
Foot insert plastazote or eq |
1,970 |
1,050 |
$163K |
| L3216 |
Orthoped ladies shoes dpth i |
576 |
305 |
$32K |
| L4361 |
Pneuma/vac walk boot pre ots |
185 |
168 |
$31K |
| L2820 |
Soft interface below knee se |
564 |
386 |
$19K |
| L2840 |
Tibial length sock fx or equ |
263 |
159 |
$13K |
| L2768 |
Ortho sidebar disconnect |
127 |
64 |
$12K |
| L2275 |
Plastic mod low ext pad/line |
121 |
78 |
$10K |
| L5673 |
Socket insert w lock mech |
15 |
13 |
$7K |
| L1833 |
Ko adj jnt pos r sup pre ots |
26 |
24 |
$7K |
| L3221 |
Orthopedic mens shoes dpth i |
54 |
38 |
$5K |
| L3202 |
Oxford w/ supinat/pronator c |
92 |
42 |
$4K |
| L3150 |
Abduct rotation bar w/o shoe |
42 |
39 |
$2K |
| L0174 |
Cerv sr 2pc thor ext pre ots |
12 |
12 |
$1K |