| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Molded inner boot |
2,182 |
921 |
$323K |
| L1970 |
Afo plastic molded w/ankle j |
809 |
379 |
$218K |
| L2275 |
Plastic mod low ext pad/line |
3,005 |
1,330 |
$142K |
| L2999 |
Lower extremity orthosis nos |
3,053 |
1,174 |
$124K |
| L1907 |
Afo supramalleolar custom |
304 |
134 |
$75K |
| L2820 |
Soft interface below knee se |
1,567 |
702 |
$49K |
| L2270 |
Varus/valgus strap padded/li |
2,296 |
1,050 |
$45K |
| L2200 |
Limited ankle motion ea jnt |
778 |
365 |
$20K |
| L1960 |
Afo pos solid ank plastic mo |
70 |
37 |
$20K |
| L5679 |
Socket insert w/o lock mech |
18 |
12 |
$8K |
| L4205 |
Ortho dvc repair per 15 min |
46 |
25 |
$3K |
| L5620 |
Test socket below knee |
24 |
12 |
$2K |
| L2840 |
Tibial length sock fx or equ |
34 |
17 |
$2K |
| L8420 |
Prosthetic sock multi ply bk |
63 |
39 |
$2K |
| E1399 |
Durable medical equipment mi |
17 |
14 |
$1K |
| L8400 |
Sheath below knee |
41 |
25 |
$1K |
| L8470 |
Pros sock single ply bk |
63 |
39 |
$479.55 |