| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3010 |
Foot longitudinal arch suppo |
1,827 |
1,144 |
$250K |
| L1960 |
Afo pos solid ank plastic mo |
479 |
321 |
$162K |
| L2280 |
Molded inner boot |
301 |
199 |
$82K |
| L2820 |
Soft interface below knee se |
1,335 |
920 |
$74K |
| L2275 |
Plastic mod low ext pad/line |
357 |
254 |
$33K |
| L4361 |
Pneuma/vac walk boot pre ots |
137 |
127 |
$21K |
| L1970 |
Afo plastic molded w/ankle j |
50 |
36 |
$21K |
| L1820 |
Ko elas w/ condyle pads & jo |
159 |
134 |
$9K |
| L3908 |
Who cock-up nonmolde pre ots |
279 |
254 |
$9K |
| L5679 |
Socket insert w/o lock mech |
16 |
14 |
$4K |
| L5685 |
Below knee sus/seal sleeve |
13 |
12 |
$783.89 |
| L8420 |
Prosthetic sock multi ply bk |
14 |
13 |
$467.59 |