| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2840 |
Tibial length sock fx or equ |
1,926 |
781 |
$233K |
| L2280 |
Molded inner boot |
655 |
278 |
$176K |
| L2275 |
Plastic mod low ext pad/line |
2,149 |
884 |
$148K |
| L2820 |
Soft interface below knee se |
1,501 |
680 |
$64K |
| L1907 |
Afo supramalleolar custom |
137 |
56 |
$46K |
| L3202 |
Oxford w/ supinat/pronator c |
1,239 |
498 |
$32K |
| L1960 |
Afo pos solid ank plastic mo |
92 |
43 |
$30K |
| L1970 |
Afo plastic molded w/ankle j |
44 |
25 |
$23K |
| L5673 |
Socket insert w lock mech |
14 |
12 |
$4K |
| A5500 |
Diab shoe for density insert |
120 |
44 |
$2K |
| L2200 |
Limited ankle motion ea jnt |
20 |
12 |
$766.91 |
| A5513 |
Multi den insert custom mold |
37 |
12 |
$744.58 |