| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Molded inner boot |
164 |
141 |
$96K |
| L1960 |
Afo pos solid ank plastic mo |
65 |
57 |
$37K |
| L2275 |
Plastic mod low ext pad/line |
125 |
115 |
$23K |
| L2340 |
Pre-tibial shell molded to p |
49 |
46 |
$21K |
| L2820 |
Soft interface below knee se |
144 |
133 |
$14K |
| L3010 |
Foot longitudinal arch suppo |
23 |
13 |
$5K |
| L2270 |
Varus/valgus strap padded/li |
73 |
61 |
$5K |
| L2755 |
Carbon graphite lamination |
17 |
13 |
$2K |
| L3332 |
Shoe lifts tapered to one-ha |
30 |
30 |
$1K |
| L3334 |
Shoe lifts elevation heel /i |
27 |
27 |
$1K |
| L2840 |
Tibial length sock fx or equ |
12 |
12 |
$747.00 |