| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Molded inner boot |
2,439 |
1,974 |
$1.14M |
| L1970 |
Afo plastic molded w/ankle j |
958 |
786 |
$634K |
| L1960 |
Afo pos solid ank plastic mo |
1,054 |
891 |
$617K |
| L2275 |
Plastic mod low ext pad/line |
3,854 |
3,214 |
$486K |
| L2820 |
Soft interface below knee se |
4,128 |
3,451 |
$336K |
| L1907 |
Afo supramalleolar custom |
296 |
263 |
$196K |
| L2220 |
Dorsi & plantar flex ass/res |
438 |
351 |
$56K |
| A5500 |
Diab shoe for density insert |
1,169 |
735 |
$26K |
| L1930 |
Afo plastic |
60 |
51 |
$15K |
| A5512 |
Multi den insert direct form |
296 |
187 |
$8K |
| L3020 |
Foot longitud/metatarsal sup |
16 |
14 |
$4K |
| L2300 |
Abduction bar jointed adjust |
12 |
12 |
$3K |
| L2200 |
Limited ankle motion ea jnt |
14 |
12 |
$2K |
| L3211 |
Surgical boot each junior |
13 |
13 |
$808.68 |
| A5513 |
Multi den insert custom mold |
19 |
13 |
$137.24 |