| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L5673 |
Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism |
79 |
65 |
$19K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
40 |
37 |
$3K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
14 |
12 |
$2K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
13 |
12 |
$1K |
| L8420 |
Prosthetic sock, multiple ply, below knee, each |
18 |
12 |
$617.84 |
| L8470 |
Prosthetic sock, single ply, fitting, below knee, each |
18 |
12 |
$116.48 |