| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1971 |
Afo w/ankle joint, prefab |
242 |
124 |
$71K |
| L2820 |
Soft interface below knee se |
1,932 |
1,121 |
$60K |
| L1940 |
Afo molded to patient plasti |
275 |
158 |
$43K |
| L2768 |
Ortho sidebar disconnect |
458 |
233 |
$37K |
| L2275 |
Plastic mod low ext pad/line |
1,937 |
1,051 |
$19K |
| L2200 |
Limited ankle motion ea jnt |
564 |
307 |
$18K |
| L2270 |
Varus/valgus strap padded/li |
620 |
358 |
$15K |
| L2280 |
Molded inner boot |
92 |
54 |
$14K |
| L1907 |
Afo supramalleolar custom |
594 |
301 |
$8K |
| L5673 |
Socket insert w lock mech |
24 |
24 |
$6K |
| L1970 |
Afo plastic molded w/ankle j |
25 |
16 |
$3K |
| L8420 |
Prosthetic sock multi ply bk |
13 |
12 |
$339.12 |
| L8470 |
Pros sock single ply bk |
42 |
37 |
$290.37 |
| A5500 |
Diab shoe for density insert |
75 |
38 |
$225.68 |