| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1960 |
Afo pos solid ank plastic mo |
538 |
349 |
$217K |
| L1970 |
Afo plastic molded w/ankle j |
112 |
82 |
$60K |
| L2275 |
Plastic mod low ext pad/line |
1,427 |
911 |
$25K |
| L3221 |
Orthopedic mens shoes dpth i |
883 |
556 |
$18K |
| L3216 |
Orthoped ladies shoes dpth i |
517 |
319 |
$14K |
| L3000 |
Ft insert ucb berkeley shell |
80 |
44 |
$8K |
| L2820 |
Soft interface below knee se |
962 |
607 |
$5K |
| L3040 |
Ft arch suprt premold longit |
55 |
28 |
$3K |
| L4205 |
Ortho dvc repair per 15 min |
83 |
81 |
$2K |
| L0984 |
Protect body sock ea pre ots |
12 |
12 |
$236.88 |
| L2200 |
Limited ankle motion ea jnt |
53 |
36 |
$117.10 |
| L1060 |
Thoracic pad |
12 |
12 |
$63.82 |
| L1210 |
Lateral thoracic extension |
12 |
12 |
$63.82 |
| L1290 |
Lateral trochanteric pad |
12 |
12 |
$61.12 |