| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
615 |
596 |
$55K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
759 |
716 |
$17K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
97 |
94 |
$3K |
| L3260 |
Surgical boot/shoe, each |
14 |
13 |
$470.91 |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
14 |
14 |
$434.01 |