| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
400 |
388 |
$95K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
70 |
70 |
$31K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
117 |
101 |
$17K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
172 |
148 |
$15K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
69 |
64 |
$14K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
43 |
33 |
$6K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
50 |
25 |
$6K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
21 |
12 |
$3K |
| L2755 |
Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only |
16 |
15 |
$3K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
32 |
25 |
$3K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
15 |
13 |
$474.24 |