| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
21,048 |
15,208 |
$3.87M |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
10,134 |
7,411 |
$669K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
10,710 |
7,804 |
$633K |
| L4210 |
Repair of orthotic device, repair or replace minor parts |
853 |
607 |
$36K |
| L2114 |
Ankle foot orthosis, fracture orthosis, tibial fracture orthosis, semi-rigid, prefabricated, includes fitting and adjustment |
140 |
140 |
$35K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
20 |
20 |
$8K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
285 |
282 |
$7K |
| L3807 |
Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
58 |
57 |
$5K |
| L2300 |
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable |
20 |
20 |
$2K |
| L3215 |
Orthopedic footwear, ladies shoe, oxford, each |
14 |
14 |
$1K |
| L3360 |
Sole wedge, outside sole |
16 |
16 |
$460.80 |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
13 |
13 |
$459.60 |
| A4565 |
Slings |
67 |
67 |
$259.96 |