| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Molded inner boot |
3,020 |
1,671 |
$883K |
| L1970 |
Afo plastic molded w/ankle j |
1,020 |
578 |
$646K |
| L2275 |
Plastic mod low ext pad/line |
3,772 |
2,089 |
$342K |
| L2270 |
Varus/valgus strap padded/li |
3,628 |
2,012 |
$119K |
| L2220 |
Dorsi & plantar flex ass/res |
804 |
455 |
$94K |
| L1960 |
Afo pos solid ank plastic mo |
187 |
104 |
$84K |
| L1300 |
Body jacket mold to patient |
29 |
29 |
$38K |
| L1907 |
Afo supramalleolar custom |
81 |
43 |
$34K |
| L1200 |
Furnsh initial orthosis only |
32 |
32 |
$33K |
| L1930 |
Afo plastic |
192 |
153 |
$28K |
| L3908 |
Who cock-up nonmolde pre ots |
540 |
534 |
$26K |
| L3984 |
Upper ext fx orthosis wrist |
93 |
91 |
$21K |
| L4205 |
Ortho dvc repair per 15 min |
483 |
469 |
$20K |
| L1210 |
Lateral thoracic extension |
60 |
60 |
$12K |
| L0455 |
Tlso flex trnk sj-t9 pre ots |
26 |
26 |
$5K |
| L4002 |
Replace strap, any orthosis |
113 |
92 |
$5K |
| L4210 |
Orth dev repair/repl minor p |
106 |
99 |
$5K |
| L2112 |
Afo tibial fracture soft |
12 |
12 |
$4K |
| L1290 |
Lateral trochanteric pad |
47 |
47 |
$2K |
| L1240 |
Lumbar derotation pad |
33 |
33 |
$2K |
| L0984 |
Protect body sock ea pre ots |
43 |
43 |
$1K |
| L1270 |
Abdominal pad |
30 |
30 |
$1K |
| L1260 |
Anterior thoracic derotation |
31 |
31 |
$1K |
| L1280 |
Rib gusset (elastic) each |
13 |
13 |
$760.33 |
| L1040 |
Lumbar or lumbar rib pad |
15 |
15 |
$588.94 |