| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
163 |
161 |
$143K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
497 |
481 |
$77K |
| L2280 |
Addition to lower extremity, molded inner boot |
146 |
141 |
$58K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
541 |
538 |
$46K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
176 |
163 |
$17K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
29 |
29 |
$14K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
181 |
171 |
$6K |
| L2755 |
Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only |
13 |
13 |
$2K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
12 |
12 |
$1K |