| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3206 |
Hightop w/ supp/pronator chi |
400 |
388 |
$95K |
| L3000 |
Ft insert ucb berkeley shell |
70 |
70 |
$31K |
| L2275 |
Plastic mod low ext pad/line |
117 |
101 |
$17K |
| L2820 |
Soft interface below knee se |
172 |
148 |
$15K |
| L3010 |
Foot longitudinal arch suppo |
69 |
64 |
$14K |
| L3221 |
Orthopedic mens shoes dpth i |
43 |
33 |
$6K |
| L3216 |
Orthoped ladies shoes dpth i |
50 |
25 |
$6K |
| A5500 |
Diab shoe for density insert |
21 |
12 |
$3K |
| L2755 |
Carbon graphite lamination |
16 |
15 |
$3K |
| L2270 |
Varus/valgus strap padded/li |
32 |
25 |
$3K |
| L2840 |
Tibial length sock fx or equ |
15 |
13 |
$474.24 |