| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S1040 |
Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) |
825 |
729 |
$1.21M |
| A8003 |
Helmet, protective, hard, custom fabricated, includes all components and accessories |
256 |
242 |
$675K |
| L2280 |
Addition to lower extremity, molded inner boot |
22 |
12 |
$10K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
66 |
39 |
$8K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
40 |
25 |
$8K |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
116 |
66 |
$5K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
43 |
26 |
$4K |