| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2275 |
Plastic mod low ext pad/line |
1,008 |
770 |
$109K |
| L2820 |
Soft interface below knee se |
815 |
633 |
$62K |
| L4361 |
Pneuma/vac walk boot pre ots |
388 |
350 |
$59K |
| A6533 |
Gc stocking thighlngth 18-30 |
529 |
493 |
$54K |
| A6530 |
Compression stocking bk18-30 |
599 |
541 |
$44K |
| L3908 |
Who cock-up nonmolde pre ots |
713 |
598 |
$36K |
| L1960 |
Afo pos solid ank plastic mo |
53 |
40 |
$30K |
| S1040 |
Cranial remolding orthosis |
14 |
14 |
$26K |
| L3020 |
Foot longitud/metatarsal sup |
109 |
83 |
$23K |
| A5500 |
Diab shoe for density insert |
87 |
52 |
$4K |
| A6539 |
Gc stocking waistlngth 18-30 |
42 |
40 |
$4K |
| L1820 |
Ko elas w/ condyle pads & jo |
41 |
38 |
$3K |
| A5513 |
Multi den insert custom mold |
42 |
26 |
$1K |