| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
3,775 |
1,382 |
$245K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
2,308 |
1,367 |
$203K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
5,075 |
2,086 |
$167K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
742 |
247 |
$146K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
2,592 |
952 |
$143K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
486 |
183 |
$111K |
| L1832 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
530 |
274 |
$109K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
3,515 |
1,417 |
$85K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
1,366 |
563 |
$58K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
1,173 |
620 |
$25K |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
918 |
340 |
$21K |
| L2999 |
Lower extremity orthoses, not otherwise specified |
326 |
100 |
$11K |
| L1810 |
Knee orthosis, elastic with joints, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
261 |
143 |
$9K |
| L3984 |
Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment |
94 |
45 |
$8K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
131 |
69 |
$3K |
| L3203 |
Orthopedic shoe, oxford with supinator or pronator, junior |
53 |
25 |
$2K |
| A4570 |
Splint |
327 |
144 |
$1K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
57 |
25 |
$522.32 |