| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
26 |
26 |
$17K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
315 |
309 |
$10K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
27 |
26 |
$4K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
12 |
12 |
$1K |
| L2330 |
Addition to lower extremity, lacer molded to patient model, for custom fabricated orthosis only |
27 |
26 |
$985.04 |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
27 |
26 |
$213.10 |