| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4360 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
53 |
51 |
$11K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
33 |
27 |
$5K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
29 |
14 |
$4K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
27 |
20 |
$2K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
12 |
12 |
$1K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
27 |
13 |
$1K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
14 |
13 |
$799.06 |