| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4360 |
Pneumat walking boot pre cst |
1,044 |
985 |
$245K |
| L3010 |
Foot longitudinal arch suppo |
1,191 |
850 |
$239K |
| A5500 |
Diab shoe for density insert |
1,741 |
1,191 |
$90K |
| L1820 |
Ko elas w/ condyle pads & jo |
368 |
321 |
$38K |
| L4386 |
Non-pneum walk boot pre cst |
303 |
252 |
$37K |
| A5514 |
Mult den insert dir carv/cam |
787 |
563 |
$33K |
| L2820 |
Soft interface below knee se |
461 |
377 |
$25K |
| L3908 |
Who cock-up nonmolde pre ots |
391 |
366 |
$12K |
| L3807 |
Whfo w/o joints pre cst |
55 |
55 |
$11K |
| A5513 |
Multi den insert custom mold |
76 |
58 |
$3K |
| A5512 |
Multi den insert direct form |
17 |
13 |
$482.85 |