| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1970 |
Afo plastic molded w/ankle j |
4,755 |
2,768 |
$1.86M |
| L1940 |
Afo molded to patient plasti |
3,409 |
1,809 |
$1.10M |
| L2280 |
Molded inner boot |
3,955 |
2,105 |
$937K |
| L2275 |
Plastic mod low ext pad/line |
11,240 |
6,163 |
$723K |
| L2820 |
Soft interface below knee se |
11,428 |
6,300 |
$710K |
| L2220 |
Dorsi & plantar flex ass/res |
2,948 |
1,572 |
$249K |
| L2270 |
Varus/valgus strap padded/li |
5,163 |
2,818 |
$208K |
| L3906 |
Who w/o joints cf |
624 |
425 |
$182K |
| L2034 |
Kafo pla sin up w/wo k/a cus |
146 |
77 |
$158K |
| L1907 |
Afo supramalleolar custom |
475 |
266 |
$150K |
| L1960 |
Afo pos solid ank plastic mo |
453 |
248 |
$132K |
| L2200 |
Limited ankle motion ea jnt |
2,434 |
1,291 |
$84K |
| L2768 |
Ortho sidebar disconnect |
884 |
457 |
$69K |
| L2340 |
Pre-tibial shell molded to p |
203 |
106 |
$48K |
| L4205 |
Ortho dvc repair per 15 min |
718 |
566 |
$45K |
| A5513 |
Multi den insert custom mold |
838 |
438 |
$45K |
| S1040 |
Cranial remolding orthosis |
12 |
12 |
$28K |
| L3809 |
Whfo w/o joints pre ots |
153 |
101 |
$23K |
| A5500 |
Diab shoe for density insert |
584 |
290 |
$19K |
| L4002 |
Replace strap, any orthosis |
682 |
414 |
$13K |
| L1930 |
Afo plastic |
50 |
25 |
$7K |
| L2760 |
Extension per extension per |
169 |
87 |
$6K |
| L3540 |
Ortho shoe add full sole |
13 |
13 |
$455.67 |