| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
1,091 |
944 |
$91K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
350 |
306 |
$40K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
206 |
195 |
$20K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
194 |
167 |
$20K |
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
13 |
13 |
$8K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
12 |
12 |
$5K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
12 |
12 |
$519.74 |