| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L5673 |
Socket insert w lock mech |
504 |
449 |
$126K |
| L5671 |
Bk/ak locking mechanism |
447 |
405 |
$56K |
| L5645 |
Bk flex inner socket ext fra |
208 |
185 |
$30K |
| L5620 |
Test socket below knee |
303 |
269 |
$27K |
| L5637 |
Below knee total contact |
269 |
243 |
$26K |
| L5940 |
Endo bk ultra-light material |
188 |
167 |
$26K |
| L5910 |
Endo below knee alignable sy |
269 |
241 |
$25K |
| L5629 |
Below knee acrylic socket |
237 |
210 |
$21K |
| L5649 |
Isch containmt/narrow m-l so |
13 |
12 |
$10K |
| L8420 |
Prosthetic sock multi ply bk |
288 |
259 |
$8K |
| L5301 |
Bk mold socket sach ft endo |
14 |
12 |
$7K |
| L5986 |
Multi-axial rotation unit |
46 |
41 |
$7K |
| L3807 |
Whfo w/o joints pre cst |
252 |
198 |
$7K |
| L5651 |
Ak flex inner socket ext fra |
13 |
12 |
$6K |
| L1831 |
Knee orth pos locking joint |
180 |
124 |
$4K |
| L2275 |
Plastic mod low ext pad/line |
106 |
92 |
$4K |
| A5500 |
Diab shoe for density insert |
114 |
62 |
$3K |
| L2820 |
Soft interface below knee se |
90 |
76 |
$3K |
| L5650 |
Tot contact ak/knee disart s |
13 |
12 |
$3K |
| L5972 |
Flexible keel foot |
25 |
25 |
$3K |
| L1832 |
Ko adj jnt pos r sup pre cst |
18 |
13 |
$2K |
| L5704 |
Custom shape cover bk |
15 |
13 |
$2K |
| L8470 |
Pros sock single ply bk |
247 |
224 |
$1K |
| L4396 |
Static or dynami afo pre cst |
40 |
26 |
$931.53 |
| A5512 |
Multi den insert direct form |
43 |
24 |
$739.29 |
| L3760 |
Eo adj jt prefab custom fit |
17 |
12 |
$403.70 |