| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,303 |
811 |
$114K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
100 |
58 |
$29K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
234 |
228 |
$22K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
275 |
233 |
$15K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
187 |
178 |
$4K |
| 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 |
54 |
37 |
$3K |
| L2280 |
Addition to lower extremity, molded inner boot |
19 |
15 |
$3K |
| L3995 |
Addition to upper extremity orthosis, sock, fracture or equal, each |
12 |
12 |
$87.30 |