| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1907 |
Afo supramalleolar custom |
124 |
73 |
$66K |
| L4361 |
Pneuma/vac walk boot pre ots |
252 |
212 |
$44K |
| L2275 |
Plastic mod low ext pad/line |
348 |
200 |
$31K |
| L1833 |
Ko adj jnt pos r sup pre ots |
67 |
56 |
$23K |
| L3020 |
Foot longitud/metatarsal sup |
40 |
32 |
$7K |
| L2280 |
Molded inner boot |
28 |
12 |
$6K |
| L3670 |
So acro/clav can web pre ots |
187 |
146 |
$6K |
| L3202 |
Oxford w/ supinat/pronator c |
100 |
65 |
$6K |
| L3908 |
Who cock-up nonmolde pre ots |
148 |
114 |
$5K |
| L2820 |
Soft interface below knee se |
38 |
27 |
$3K |
| A5500 |
Diab shoe for density insert |
32 |
16 |
$248.20 |