| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1820 |
Ko elas w/ condyle pads & jo |
1,897 |
1,757 |
$161K |
| L1906 |
Afo multilig ank sup pre ots |
1,501 |
1,464 |
$124K |
| L3908 |
Who cock-up nonmolde pre ots |
1,803 |
1,571 |
$86K |
| L4387 |
Non-pneum walk boot pre ots |
759 |
758 |
$73K |
| L4360 |
Pneumat walking boot pre cst |
269 |
269 |
$55K |
| A5500 |
Diab shoe for density insert |
1,370 |
836 |
$47K |
| L3020 |
Foot longitud/metatarsal sup |
218 |
124 |
$38K |
| L4361 |
Pneuma/vac walk boot pre ots |
165 |
165 |
$36K |
| L1970 |
Afo plastic molded w/ankle j |
65 |
56 |
$34K |
| L4386 |
Non-pneum walk boot pre cst |
280 |
280 |
$29K |
| A6530 |
Compression stocking bk18-30 |
244 |
199 |
$21K |
| L5673 |
Socket insert w lock mech |
26 |
25 |
$16K |
| L2275 |
Plastic mod low ext pad/line |
219 |
196 |
$14K |
| L2820 |
Soft interface below knee se |
231 |
196 |
$12K |
| L1832 |
Ko adj jnt pos r sup pre cst |
25 |
25 |
$12K |
| A5513 |
Multi den insert custom mold |
297 |
192 |
$9K |
| L1845 |
Ko double upright pre cst |
15 |
14 |
$6K |
| L1960 |
Afo pos solid ank plastic mo |
14 |
12 |
$5K |
| L1951 |
Afo spiral prefab custom |
13 |
12 |
$5K |
| A5512 |
Multi den insert direct form |
120 |
85 |
$5K |
| L3670 |
So acro/clav can web pre ots |
28 |
28 |
$2K |
| L0621 |
Sio flex pelvic/sacr pre ots |
26 |
26 |
$2K |