| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S1040 |
Cranial remolding orthosis |
1,275 |
1,265 |
$5.00M |
| L4361 |
Pneuma/vac walk boot pre ots |
735 |
725 |
$159K |
| L2275 |
Plastic mod low ext pad/line |
875 |
473 |
$62K |
| L2820 |
Soft interface below knee se |
854 |
493 |
$58K |
| L1940 |
Afo molded to patient plasti |
121 |
66 |
$41K |
| L3000 |
Ft insert ucb berkeley shell |
142 |
71 |
$32K |
| L2270 |
Varus/valgus strap padded/li |
527 |
289 |
$24K |
| L3908 |
Who cock-up nonmolde pre ots |
473 |
249 |
$22K |
| L2280 |
Molded inner boot |
81 |
47 |
$21K |
| L4387 |
Non-pneum walk boot pre ots |
12 |
12 |
$1K |
| A5500 |
Diab shoe for density insert |
25 |
12 |
$1K |