| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1970 |
Afo plastic molded w/ankle j |
1,658 |
936 |
$960K |
| L2275 |
Plastic mod low ext pad/line |
5,554 |
2,831 |
$514K |
| L2280 |
Molded inner boot |
908 |
458 |
$327K |
| L1200 |
Furnsh initial orthosis only |
186 |
169 |
$238K |
| L1907 |
Afo supramalleolar custom |
442 |
225 |
$209K |
| L2200 |
Limited ankle motion ea jnt |
2,031 |
1,097 |
$69K |
| L3010 |
Foot longitudinal arch suppo |
382 |
181 |
$54K |
| L1960 |
Afo pos solid ank plastic mo |
124 |
64 |
$47K |
| L1210 |
Lateral thoracic extension |
162 |
145 |
$30K |
| L0984 |
Protect body sock ea pre ots |
298 |
250 |
$16K |
| L1240 |
Lumbar derotation pad |
175 |
157 |
$12K |
| L2820 |
Soft interface below knee se |
167 |
88 |
$11K |
| L1290 |
Lateral trochanteric pad |
135 |
120 |
$10K |
| L1060 |
Thoracic pad |
12 |
12 |
$999.64 |