| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1960 |
Afo pos solid ank plastic mo |
1,932 |
1,109 |
$551K |
| L2275 |
Plastic mod low ext pad/line |
3,904 |
2,272 |
$243K |
| L2820 |
Soft interface below knee se |
3,895 |
2,387 |
$231K |
| L2270 |
Varus/valgus strap padded/li |
3,824 |
2,224 |
$142K |
| L1970 |
Afo plastic molded w/ankle j |
219 |
148 |
$90K |
| A5500 |
Diab shoe for density insert |
1,638 |
851 |
$59K |
| L3000 |
Ft insert ucb berkeley shell |
139 |
81 |
$34K |
| S1040 |
Cranial remolding orthosis |
16 |
16 |
$25K |
| L2220 |
Dorsi & plantar flex ass/res |
220 |
133 |
$19K |
| A5513 |
Multi den insert custom mold |
698 |
391 |
$15K |
| L1930 |
Afo plastic |
55 |
28 |
$7K |
| L4386 |
Non-pneum walk boot pre cst |
64 |
63 |
$6K |
| L2280 |
Molded inner boot |
24 |
14 |
$6K |
| L1832 |
Ko adj jnt pos r sup pre cst |
26 |
25 |
$5K |
| L4361 |
Pneuma/vac walk boot pre ots |
43 |
42 |
$2K |
| L2795 |
Knee control full kneecap |
17 |
14 |
$973.27 |