| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
3,208 |
2,618 |
$259K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
2,050 |
1,708 |
$174K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
981 |
802 |
$122K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
1,468 |
1,145 |
$90K |
| L3254 |
Non-standard size or width |
3,149 |
2,595 |
$47K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
307 |
265 |
$38K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
129 |
118 |
$33K |
| L3255 |
Non-standard size or length |
152 |
133 |
$2K |
| L3222 |
Orthopedic footwear, mens shoe, hightop, depth inlay, each |
15 |
14 |
$2K |