| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Ft insert ucb berkeley shell |
5,609 |
2,802 |
$966K |
| L3410 |
Shoe metatarsal bar between |
6,607 |
3,303 |
$284K |
| L1907 |
Afo supramalleolar custom |
700 |
347 |
$214K |
| L2330 |
Lacer molded to patient mode |
700 |
347 |
$202K |
| L3370 |
Shoe sole wedge between sole |
7,751 |
3,875 |
$178K |
| L3219 |
Orthopedic mens shoes oxford |
1,740 |
869 |
$102K |
| L3030 |
Foot arch support remov prem |
2,287 |
1,144 |
$101K |
| L3215 |
Orthopedic ftwear ladies oxf |
1,976 |
987 |
$98K |
| L3202 |
Oxford w/ supinat/pronator c |
2,976 |
1,487 |
$68K |
| L3485 |
Shoe heel pad removable for |
2,907 |
1,453 |
$67K |
| L2275 |
Plastic mod low ext pad/line |
700 |
347 |
$49K |
| L3217 |
Ladies shoes hightop depth i |
690 |
345 |
$36K |
| L3222 |
Mens shoes hightop depth inl |
362 |
181 |
$23K |
| L3206 |
Hightop w/ supp/pronator chi |
684 |
340 |
$16K |
| L3010 |
Foot longitudinal arch suppo |
62 |
30 |
$7K |
| L3216 |
Orthoped ladies shoes dpth i |
38 |
19 |
$1K |