| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
642 |
406 |
$128K |
| L2340 |
Addition to lower extremity, pre-tibial shell, molded to patient model |
101 |
67 |
$26K |
| L2755 |
Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only |
288 |
149 |
$22K |
| L2280 |
Addition to lower extremity, molded inner boot |
18 |
13 |
$6K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
46 |
30 |
$4K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
124 |
81 |
$3K |