| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3010 |
Foot longitudinal arch suppo |
5,857 |
4,212 |
$1.25M |
| L1960 |
Afo pos solid ank plastic mo |
1,267 |
934 |
$779K |
| L1970 |
Afo plastic molded w/ankle j |
1,024 |
713 |
$711K |
| L5673 |
Socket insert w lock mech |
744 |
594 |
$558K |
| L2280 |
Molded inner boot |
791 |
516 |
$541K |
| A5500 |
Diab shoe for density insert |
6,852 |
4,836 |
$431K |
| L2275 |
Plastic mod low ext pad/line |
3,297 |
2,396 |
$415K |
| L3000 |
Ft insert ucb berkeley shell |
842 |
579 |
$345K |
| L2820 |
Soft interface below knee se |
4,304 |
3,248 |
$334K |
| L1907 |
Afo supramalleolar custom |
351 |
210 |
$256K |
| A5514 |
Mult den insert dir carv/cam |
4,640 |
3,312 |
$222K |
| L4361 |
Pneuma/vac walk boot pre ots |
1,523 |
1,488 |
$159K |
| L0174 |
Cerv sr 2pc thor ext pre ots |
662 |
612 |
$147K |
| L3202 |
Oxford w/ supinat/pronator c |
1,151 |
708 |
$99K |
| L3216 |
Orthoped ladies shoes dpth i |
838 |
627 |
$95K |
| L5671 |
Bk/ak locking mechanism |
254 |
201 |
$80K |
| L5000 |
Sho insert w arch toe filler |
182 |
164 |
$75K |
| L3260 |
Ambulatory surgical boot eac |
1,131 |
1,076 |
$68K |
| L3670 |
So acro/clav can web pre ots |
2,284 |
2,206 |
$61K |
| S1040 |
Cranial remolding orthosis |
39 |
31 |
$59K |
| L3221 |
Orthopedic mens shoes dpth i |
328 |
265 |
$42K |
| L0625 |
Lo flex l1-below l5 pre ots |
1,034 |
999 |
$40K |
| L3984 |
Upper ext fx orthosis wrist |
144 |
143 |
$40K |
| L5637 |
Below knee total contact |
164 |
134 |
$39K |
| L5940 |
Endo bk ultra-light material |
117 |
93 |
$36K |
| L5620 |
Test socket below knee |
155 |
123 |
$36K |
| E0114 |
Crutch underarm pair no wood |
985 |
970 |
$32K |
| E0143 |
Walker folding wheeled w/o s |
378 |
365 |
$30K |
| L8420 |
Prosthetic sock multi ply bk |
412 |
330 |
$26K |
| L5629 |
Below knee acrylic socket |
131 |
108 |
$26K |
| L1940 |
Afo molded to patient plasti |
62 |
58 |
$21K |
| L0621 |
Sio flex pelvic/sacr pre ots |
300 |
300 |
$18K |
| L3908 |
Who cock-up nonmolde pre ots |
645 |
605 |
$17K |
| A5513 |
Multi den insert custom mold |
332 |
272 |
$16K |
| L1830 |
Ko immob canvas long pre ots |
463 |
454 |
$14K |
| L2840 |
Tibial length sock fx or equ |
126 |
104 |
$12K |
| L4360 |
Pneumat walking boot pre cst |
51 |
42 |
$12K |
| K0903 |
Mult den insert dir carv/cam |
258 |
193 |
$12K |
| L5910 |
Endo below knee alignable sy |
46 |
40 |
$11K |
| A5512 |
Multi den insert direct form |
306 |
246 |
$9K |
| L1820 |
Ko elas w/ condyle pads & jo |
71 |
68 |
$9K |
| L2330 |
Lacer molded to patient mode |
31 |
31 |
$9K |
| L8470 |
Pros sock single ply bk |
253 |
219 |
$5K |
| L3809 |
Whfo w/o joints pre ots |
39 |
39 |
$4K |
| L8440 |
Shrinker below knee |
76 |
67 |
$4K |
| L3995 |
Sock fracture or equal each |
133 |
131 |
$3K |
| L3807 |
Whfo w/o joints pre cst |
14 |
12 |
$3K |
| L2210 |
Dorsiflexion assist each joi |
20 |
16 |
$2K |
| L0172 |
Cerv col sr foam 2pc pre ots |
26 |
25 |
$2K |
| L4386 |
Non-pneum walk boot pre cst |
12 |
12 |
$1K |
| A4565 |
Slings |
53 |
51 |
$867.71 |
| L0999 |
Add to spinal orthosis nos |
56 |
55 |
$707.37 |
| L3650 |
So 8 abd restraint pre ots |
16 |
15 |
$451.06 |