| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1907 |
Afo supramalleolar custom |
1,328 |
686 |
$428K |
| L2280 |
Molded inner boot |
1,489 |
747 |
$420K |
| L2275 |
Plastic mod low ext pad/line |
2,752 |
1,375 |
$410K |
| L3010 |
Foot longitudinal arch suppo |
2,445 |
1,273 |
$267K |
| L1970 |
Afo plastic molded w/ankle j |
230 |
116 |
$103K |
| L2820 |
Soft interface below knee se |
1,271 |
672 |
$64K |
| A5514 |
Mult den insert dir carv/cam |
922 |
461 |
$50K |
| L1960 |
Afo pos solid ank plastic mo |
89 |
51 |
$36K |
| A5500 |
Diab shoe for density insert |
1,052 |
522 |
$27K |
| L2210 |
Dorsiflexion assist each joi |
23 |
12 |
$1K |
| L3060 |
Foot arch supp longitud/meta |
29 |
14 |
$997.68 |