| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3002 |
Foot, insert, removable, molded to patient model, plastazote or equal, each |
344 |
328 |
$30K |
| L1906 |
Ankle foot orthosis, multiligamentous ankle support, prefabricated, off-the-shelf |
736 |
563 |
$28K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
552 |
339 |
$21K |
| L3050 |
Foot, arch support, removable, premolded, metatarsal, each |
330 |
201 |
$5K |
| L4396 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
34 |
29 |
$2K |
| L3224 |
Orthopedic footwear, woman's shoe, oxford, used as an integral part of a brace (orthosis) |
18 |
18 |
$1K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
12 |
12 |
$1K |