| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L5673 |
Socket insert w lock mech |
137 |
106 |
$57K |
| L5679 |
Socket insert w/o lock mech |
123 |
80 |
$55K |
| L5645 |
Bk flex inner socket ext fra |
119 |
95 |
$30K |
| L5301 |
Bk mold socket sach ft endo |
17 |
15 |
$17K |
| L5940 |
Endo bk ultra-light material |
131 |
108 |
$16K |
| L5620 |
Test socket below knee |
161 |
125 |
$16K |
| L5637 |
Below knee total contact |
131 |
108 |
$12K |
| L8440 |
Shrinker below knee |
712 |
565 |
$11K |
| L8420 |
Prosthetic sock multi ply bk |
317 |
251 |
$10K |
| L5629 |
Below knee acrylic socket |
115 |
95 |
$10K |
| L5910 |
Endo below knee alignable sy |
99 |
83 |
$9K |
| L5671 |
Bk/ak locking mechanism |
56 |
41 |
$7K |
| L8400 |
Sheath below knee |
235 |
182 |
$5K |
| L8470 |
Pros sock single ply bk |
115 |
96 |
$994.88 |
| L5685 |
Below knee sus/seal sleeve |
19 |
16 |
$756.16 |
| L8460 |
Shrinker above knee |
13 |
12 |
$185.88 |