| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3216 |
Orthoped ladies shoes dpth i |
1,280 |
920 |
$181K |
| L3010 |
Foot longitudinal arch suppo |
1,034 |
682 |
$175K |
| L3020 |
Foot longitud/metatarsal sup |
398 |
311 |
$107K |
| A5500 |
Diab shoe for density insert |
2,005 |
1,231 |
$73K |
| A5513 |
Multi den insert custom mold |
1,297 |
830 |
$67K |
| L3221 |
Orthopedic mens shoes dpth i |
469 |
348 |
$67K |
| A5514 |
Mult den insert dir carv/cam |
572 |
374 |
$53K |
| L1970 |
Afo plastic molded w/ankle j |
15 |
13 |
$6K |
| L2820 |
Soft interface below knee se |
58 |
49 |
$6K |
| L5679 |
Socket insert w/o lock mech |
13 |
12 |
$5K |
| L2275 |
Plastic mod low ext pad/line |
29 |
27 |
$3K |
| L5629 |
Below knee acrylic socket |
13 |
12 |
$2K |