| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Pneuma/vac walk boot pre ots |
569 |
554 |
$100K |
| L2280 |
Molded inner boot |
246 |
155 |
$75K |
| L2275 |
Plastic mod low ext pad/line |
540 |
353 |
$47K |
| E0114 |
Crutch underarm pair no wood |
993 |
985 |
$32K |
| L4387 |
Non-pneum walk boot pre ots |
326 |
318 |
$30K |
| L1970 |
Afo plastic molded w/ankle j |
51 |
36 |
$28K |
| L3908 |
Who cock-up nonmolde pre ots |
320 |
302 |
$14K |
| L2820 |
Soft interface below knee se |
261 |
177 |
$14K |
| L1902 |
Afo ankle gauntlet pre ots |
225 |
216 |
$11K |
| L4350 |
Ankle control ortho pre ots |
202 |
202 |
$11K |
| L3010 |
Foot longitudinal arch suppo |
80 |
44 |
$10K |
| A5500 |
Diab shoe for density insert |
252 |
189 |
$9K |
| L2999 |
Lower extremity orthosis nos |
85 |
52 |
$7K |
| L1830 |
Ko immob canvas long pre ots |
114 |
112 |
$6K |
| L2270 |
Varus/valgus strap padded/li |
183 |
122 |
$5K |
| A4580 |
Cast supplies (plaster) |
55 |
55 |
$4K |
| L1930 |
Afo plastic |
25 |
13 |
$4K |
| A5514 |
Mult den insert dir carv/cam |
70 |
53 |
$2K |
| L3202 |
Oxford w/ supinat/pronator c |
52 |
39 |
$2K |
| L1820 |
Ko elas w/ condyle pads & jo |
15 |
14 |
$589.89 |
| A4565 |
Slings |
27 |
27 |
$180.14 |