| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
131 |
130 |
$82K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
101 |
100 |
$43K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
451 |
447 |
$42K |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
576 |
570 |
$36K |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
135 |
135 |
$31K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
129 |
129 |
$28K |
| L2300 |
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable |
65 |
65 |
$13K |
| L2768 |
Orthotic side bar disconnect device, per bar |
64 |
64 |
$11K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
14 |
14 |
$3K |
| L1660 |
Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment |
25 |
25 |
$3K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
12 |
12 |
$1K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
25 |
25 |
$931.04 |
| V5266 |
Battery for use in hearing device |
40 |
40 |
$160.16 |