| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1907 |
Afo supramalleolar custom |
1,081 |
964 |
$774K |
| L2275 |
Plastic mod low ext pad/line |
1,845 |
1,624 |
$284K |
| L3202 |
Oxford w/ supinat/pronator c |
2,697 |
2,453 |
$239K |
| L3010 |
Foot longitudinal arch suppo |
859 |
706 |
$192K |
| L2820 |
Soft interface below knee se |
1,046 |
870 |
$92K |
| L2840 |
Tibial length sock fx or equ |
1,095 |
965 |
$80K |
| L1970 |
Afo plastic molded w/ankle j |
105 |
82 |
$69K |
| A5500 |
Diab shoe for density insert |
659 |
420 |
$34K |
| L3060 |
Foot arch supp longitud/meta |
85 |
78 |
$9K |
| A5513 |
Multi den insert custom mold |
102 |
97 |
$8K |
| A5514 |
Mult den insert dir carv/cam |
114 |
64 |
$6K |
| L8420 |
Prosthetic sock multi ply bk |
64 |
54 |
$2K |
| L5685 |
Below knee sus/seal sleeve |
22 |
13 |
$2K |
| L5910 |
Endo below knee alignable sy |
15 |
12 |
$851.80 |
| L5637 |
Below knee total contact |
15 |
12 |
$679.45 |
| L8470 |
Pros sock single ply bk |
66 |
55 |
$641.32 |