| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
5,609 |
2,802 |
$966K |
| L3410 |
Metatarsal bar wedge, between sole |
6,607 |
3,303 |
$284K |
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
700 |
347 |
$214K |
| L2330 |
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only |
700 |
347 |
$202K |
| L3370 |
Sole wedge, between sole |
7,751 |
3,875 |
$178K |
| L3219 |
Orthopedic footwear, mens shoe, oxford, each |
1,740 |
869 |
$102K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
2,287 |
1,144 |
$101K |
| L3215 |
Orthopedic footwear, ladies shoe, oxford, each |
1,976 |
987 |
$98K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
2,976 |
1,487 |
$68K |
| L3485 |
Heel, pad, removable for spur |
2,907 |
1,453 |
$67K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
700 |
347 |
$49K |
| L3217 |
Orthopedic footwear, ladies shoe, hightop, depth inlay, each |
690 |
345 |
$36K |
| L3222 |
Orthopedic footwear, mens shoe, hightop, depth inlay, each |
362 |
181 |
$23K |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
684 |
340 |
$16K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
62 |
30 |
$7K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
38 |
19 |
$1K |