| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Molded inner boot |
1,401 |
733 |
$473K |
| L1970 |
Afo plastic molded w/ankle j |
758 |
431 |
$382K |
| L2820 |
Soft interface below knee se |
2,356 |
1,305 |
$141K |
| L5673 |
Socket insert w lock mech |
184 |
157 |
$111K |
| L1907 |
Afo supramalleolar custom |
165 |
81 |
$75K |
| L2275 |
Plastic mod low ext pad/line |
615 |
327 |
$58K |
| L5637 |
Below knee total contact |
285 |
254 |
$42K |
| L1960 |
Afo pos solid ank plastic mo |
71 |
38 |
$33K |
| L5671 |
Bk/ak locking mechanism |
113 |
98 |
$30K |
| L5679 |
Socket insert w/o lock mech |
42 |
38 |
$23K |
| L5620 |
Test socket below knee |
92 |
81 |
$19K |
| L3202 |
Oxford w/ supinat/pronator c |
370 |
182 |
$16K |
| L8420 |
Prosthetic sock multi ply bk |
313 |
276 |
$16K |
| L5629 |
Below knee acrylic socket |
74 |
65 |
$15K |
| L5940 |
Endo bk ultra-light material |
72 |
63 |
$15K |
| L2270 |
Varus/valgus strap padded/li |
309 |
178 |
$12K |
| L2200 |
Limited ankle motion ea jnt |
96 |
47 |
$6K |
| L2210 |
Dorsiflexion assist each joi |
44 |
25 |
$5K |
| L5685 |
Below knee sus/seal sleeve |
26 |
24 |
$4K |
| L5986 |
Multi-axial rotation unit |
14 |
12 |
$3K |
| L8470 |
Pros sock single ply bk |
300 |
267 |
$3K |
| L5910 |
Endo below knee alignable sy |
15 |
13 |
$2K |
| L3310 |
Shoe lift elev heel/sole neo |
14 |
13 |
$990.94 |
| A5500 |
Diab shoe for density insert |
22 |
13 |
$783.43 |
| L8440 |
Shrinker below knee |
13 |
12 |
$469.42 |