| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| S1040 |
Cranial remolding orthosis, pediatric, rigid, with soft interface material, custom fabricated, includes fitting and adjustment(s) |
1,659 |
1,141 |
$1.68M |
| A8003 |
Helmet, protective, hard, custom fabricated, includes all components and accessories |
604 |
552 |
$1.24M |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
249 |
123 |
$99K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
458 |
282 |
$56K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
487 |
300 |
$44K |
| L2280 |
Addition to lower extremity, molded inner boot |
137 |
55 |
$42K |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
31 |
14 |
$7K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
56 |
30 |
$3K |
| L4386 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
31 |
28 |
$3K |
| L2210 |
Addition to lower extremity, dorsiflexion assist (plantar flexion resist), each joint |
42 |
13 |
$3K |
| L2220 |
Addition to lower extremity, dorsiflexion and plantar flexion assist/resist, each joint |
29 |
13 |
$3K |
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
16 |
15 |
$3K |