| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Molded inner boot |
1,786 |
814 |
$716K |
| S1040 |
Cranial remolding orthosis |
278 |
270 |
$709K |
| L2275 |
Plastic mod low ext pad/line |
1,898 |
875 |
$177K |
| L2340 |
Pre-tibial shell molded to p |
594 |
278 |
$170K |
| L2999 |
Lower extremity orthosis nos |
1,469 |
507 |
$122K |
| L1960 |
Afo pos solid ank plastic mo |
257 |
119 |
$121K |
| L2820 |
Soft interface below knee se |
1,442 |
658 |
$81K |
| L2840 |
Tibial length sock fx or equ |
1,097 |
485 |
$73K |
| L2250 |
Foot plate molded stirrup at |
66 |
26 |
$16K |
| L2220 |
Dorsi & plantar flex ass/res |
171 |
67 |
$14K |
| L2755 |
Carbon graphite lamination |
102 |
40 |
$8K |
| L3332 |
Shoe lifts tapered to one-ha |
81 |
41 |
$5K |
| L3334 |
Shoe lifts elevation heel /i |
113 |
65 |
$3K |
| L2200 |
Limited ankle motion ea jnt |
24 |
12 |
$1K |