| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
538 |
349 |
$217K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
112 |
82 |
$60K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,427 |
911 |
$25K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
883 |
556 |
$18K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
517 |
319 |
$14K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
80 |
44 |
$8K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
962 |
607 |
$5K |
| L3040 |
Foot, arch support, removable, premolded, longitudinal, each |
55 |
28 |
$3K |
| L4205 |
Repair of orthotic device, labor component, per 15 minutes |
83 |
81 |
$2K |
| L0984 |
Protective body sock, prefabricated, off-the-shelf, each |
12 |
12 |
$236.88 |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
53 |
36 |
$117.10 |
| L1060 |
Addition to ctlso or scoliosis orthosis, thoracic pad |
12 |
12 |
$63.82 |
| L1210 |
Addition to tlso, (low profile), lateral thoracic extension |
12 |
12 |
$63.82 |
| L1290 |
Addition to tlso, (low profile), lateral trochanteric pad |
12 |
12 |
$61.12 |