| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3030 |
Foot, insert, removable, formed to patient foot, each |
19,614 |
9,828 |
$864K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
5,136 |
2,567 |
$857K |
| L3219 |
Orthopedic footwear, mens shoe, oxford, each |
9,011 |
4,508 |
$519K |
| L3170 |
Foot, plastic, silicone or equal, heel stabilizer, prefabricated, off-the-shelf, each |
20,943 |
10,498 |
$490K |
| L3215 |
Orthopedic footwear, ladies shoe, oxford, each |
9,957 |
4,985 |
$488K |
| L3390 |
Outflare wedge |
18,617 |
9,324 |
$427K |
| L3400 |
Metatarsal bar wedge, rocker |
8,645 |
4,330 |
$162K |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
6,636 |
3,326 |
$141K |
| L3001 |
Foot, insert, removable, molded to patient model, spenco, each |
1,509 |
751 |
$103K |
| L3320 |
Lift, elevation, heel and sole, cork, per inch |
870 |
436 |
$41K |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
273 |
135 |
$30K |
| L3485 |
Heel, pad, removable for spur |
847 |
425 |
$19K |
| L2768 |
Orthotic side bar disconnect device, per bar |
271 |
135 |
$14K |
| L3160 |
Foot, adjustable shoe-styled positioning device |
86 |
43 |
$7K |
| L2300 |
Addition to lower extremity, abduction bar (bilateral hip involvement), jointed, adjustable |
29 |
29 |
$6K |
| L3150 |
Foot, abduction rotation bar, without shoes |
137 |
135 |
$5K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
24 |
12 |
$5K |
| L3430 |
Heel, counter, plastic reinforced |
318 |
160 |
$932.93 |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
32 |
16 |
$735.36 |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
35 |
19 |
$209.97 |