| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3030 |
Foot arch support remov prem |
43,205 |
23,102 |
$2.65M |
| L3215 |
Orthopedic ftwear ladies oxf |
15,466 |
7,980 |
$1.04M |
| L3219 |
Orthopedic mens shoes oxford |
11,009 |
5,614 |
$862K |
| L3217 |
Ladies shoes hightop depth i |
6,837 |
3,593 |
$503K |
| L3222 |
Mens shoes hightop depth inl |
4,503 |
2,359 |
$395K |
| L3216 |
Orthoped ladies shoes dpth i |
7,231 |
4,274 |
$360K |
| L3221 |
Orthopedic mens shoes dpth i |
4,135 |
2,395 |
$239K |
| L3050 |
Foot arch supp premold metat |
6,138 |
3,131 |
$201K |
| L3020 |
Foot longitud/metatarsal sup |
1,705 |
871 |
$196K |
| A6530 |
Compression stocking bk18-30 |
2,183 |
1,258 |
$60K |
| L3002 |
Foot insert plastazote or eq |
21 |
12 |
$2K |
| A5500 |
Diab shoe for density insert |
44 |
44 |
$2K |
| A5512 |
Multi den insert direct form |
44 |
44 |
$2K |