| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
33 |
33 |
$23K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
109 |
108 |
$18K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
103 |
103 |
$8K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
13 |
12 |
$1K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
12 |
12 |
$653.40 |