| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2280 |
Molded inner boot |
3,101 |
1,549 |
$915K |
| L4361 |
Pneuma/vac walk boot pre ots |
4,576 |
4,271 |
$891K |
| L1970 |
Afo plastic molded w/ankle j |
1,086 |
576 |
$478K |
| L3960 |
Sewho airplan desig abdu pos |
762 |
688 |
$303K |
| L2275 |
Plastic mod low ext pad/line |
3,819 |
1,899 |
$302K |
| L3809 |
Whfo w/o joints pre ots |
1,540 |
1,415 |
$249K |
| L2840 |
Tibial length sock fx or equ |
1,923 |
1,034 |
$232K |
| L1907 |
Afo supramalleolar custom |
658 |
348 |
$202K |
| L1820 |
Ko elas w/ condyle pads & jo |
2,938 |
2,615 |
$202K |
| L3908 |
Who cock-up nonmolde pre ots |
6,020 |
4,679 |
$196K |
| L0627 |
Lo sag ri an/pos pnl pre cst |
511 |
482 |
$127K |
| L1902 |
Afo ankle gauntlet pre ots |
2,594 |
2,348 |
$115K |
| L3984 |
Upper ext fx orthosis wrist |
508 |
472 |
$112K |
| L1812 |
Ko elastic w/joints pre ots |
880 |
806 |
$74K |
| L4360 |
Pneumat walking boot pre cst |
392 |
344 |
$52K |
| E0935 |
Cont pas motion exercise dev |
263 |
208 |
$49K |
| L3807 |
Whfo w/o joints pre cst |
310 |
274 |
$41K |
| L1832 |
Ko adj jnt pos r sup pre cst |
97 |
79 |
$38K |
| L0642 |
Lo sag ri an/pos pnl pre ots |
152 |
137 |
$36K |
| L1810 |
Ko elastic with joints |
326 |
295 |
$24K |
| L3260 |
Ambulatory surgical boot eac |
1,063 |
974 |
$19K |
| L2820 |
Soft interface below knee se |
300 |
199 |
$15K |
| L1833 |
Ko adj jnt pos r sup pre ots |
26 |
24 |
$14K |
| L0637 |
Lso sc r ant/pos pnl pre cst |
13 |
13 |
$12K |
| E0114 |
Crutch underarm pair no wood |
279 |
261 |
$9K |
| A4467 |
Belt strap sleev grmnt cover |
1,261 |
568 |
$9K |
| L2200 |
Limited ankle motion ea jnt |
303 |
158 |
$9K |
| L3020 |
Foot longitud/metatarsal sup |
63 |
24 |
$6K |
| L2210 |
Dorsiflexion assist each joi |
154 |
67 |
$6K |
| L3202 |
Oxford w/ supinat/pronator c |
72 |
39 |
$5K |
| L4397 |
Static or dynami afo pre ots |
43 |
39 |
$5K |
| L2232 |
Rocker bottom, contact afo |
69 |
38 |
$4K |
| L2220 |
Dorsi & plantar flex ass/res |
22 |
15 |
$1K |
| E0188 |
Synthetic sheepskin pad |
80 |
68 |
$1K |
| A4565 |
Slings |
181 |
170 |
$655.48 |
| L2795 |
Knee control full kneecap |
52 |
52 |
$530.79 |