| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
5,598 |
2,376 |
$970K |
| L4396 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
764 |
360 |
$83K |
| S1040 |
Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) |
12 |
12 |
$18K |