| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3410 |
Shoe metatarsal bar between |
1,420 |
1,263 |
$146K |
| L3000 |
Ft insert ucb berkeley shell |
533 |
479 |
$141K |
| L3010 |
Foot longitudinal arch suppo |
693 |
591 |
$137K |
| L3370 |
Shoe sole wedge between sole |
1,373 |
1,228 |
$85K |
| L4386 |
Non-pneum walk boot pre cst |
729 |
696 |
$85K |
| L3809 |
Whfo w/o joints pre ots |
419 |
394 |
$43K |
| L3350 |
Shoe heel wedge |
1,379 |
1,232 |
$40K |
| L0637 |
Lso sc r ant/pos pnl pre cst |
19 |
14 |
$11K |
| L3216 |
Orthoped ladies shoes dpth i |
91 |
77 |
$10K |
| A5500 |
Diab shoe for density insert |
190 |
115 |
$5K |
| L3221 |
Orthopedic mens shoes dpth i |
46 |
38 |
$5K |
| A5514 |
Mult den insert dir carv/cam |
125 |
77 |
$4K |
| L3908 |
Who cock-up nonmolde pre ots |
82 |
70 |
$2K |
| L3222 |
Mens shoes hightop depth inl |
12 |
12 |
$2K |
| L1820 |
Ko elas w/ condyle pads & jo |
14 |
13 |
$660.09 |