| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1907 |
Afo supramalleolar custom |
649 |
334 |
$147K |
| L2280 |
Molded inner boot |
357 |
186 |
$68K |
| L2275 |
Plastic mod low ext pad/line |
1,109 |
577 |
$62K |
| L1970 |
Afo plastic molded w/ankle j |
99 |
59 |
$28K |
| L1960 |
Afo pos solid ank plastic mo |
100 |
54 |
$28K |
| L2820 |
Soft interface below knee se |
437 |
241 |
$15K |
| L2270 |
Varus/valgus strap padded/li |
432 |
230 |
$8K |
| L3060 |
Foot arch supp longitud/meta |
160 |
84 |
$6K |
| L2200 |
Limited ankle motion ea jnt |
75 |
45 |
$3K |
| L3050 |
Foot arch supp premold metat |
33 |
17 |
$806.00 |