| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6549 |
Grad com garm noc day use |
862 |
447 |
$644K |
| L2840 |
Tibial length sock fx or equ |
3,106 |
1,299 |
$387K |
| L1960 |
Afo pos solid ank plastic mo |
888 |
391 |
$293K |
| L2275 |
Plastic mod low ext pad/line |
2,927 |
1,224 |
$229K |
| L2820 |
Soft interface below knee se |
3,063 |
1,291 |
$158K |
| S1040 |
Cranial remolding orthosis |
52 |
47 |
$123K |
| L2280 |
Molded inner boot |
429 |
188 |
$123K |
| L3254 |
Orth foot non-stndard size/w |
2,671 |
1,108 |
$59K |
| A5513 |
Multi den insert custom mold |
695 |
321 |
$41K |
| A6530 |
Compression stocking bk18-30 |
300 |
139 |
$39K |
| L3202 |
Oxford w/ supinat/pronator c |
1,112 |
461 |
$30K |
| A5500 |
Diab shoe for density insert |
970 |
439 |
$28K |
| L3060 |
Foot arch supp longitud/meta |
132 |
62 |
$8K |
| L3360 |
Shoe sole wedge outside sole |
28 |
13 |
$614.16 |