| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L5673 |
Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism |
67 |
38 |
$20K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
65 |
40 |
$2K |
| L8440 |
Prosthetic shrinker, below knee, each |
44 |
26 |
$853.42 |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
19 |
13 |
$184.68 |