| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3010 |
Foot longitudinal arch suppo |
12,713 |
6,351 |
$1.01M |
| L2275 |
Plastic mod low ext pad/line |
12,737 |
6,367 |
$760K |
| L3480 |
Shoe heel pad & depress for |
9,924 |
4,956 |
$281K |
| L3221 |
Orthopedic mens shoes dpth i |
2,910 |
1,455 |
$142K |
| L3410 |
Shoe metatarsal bar between |
2,959 |
1,481 |
$124K |
| L3216 |
Orthoped ladies shoes dpth i |
2,497 |
1,249 |
$109K |
| L3203 |
Oxford w/ supinator/pronator |
4,512 |
2,252 |
$85K |
| L3370 |
Shoe sole wedge between sole |
2,277 |
1,139 |
$51K |
| L3202 |
Oxford w/ supinat/pronator c |
1,562 |
781 |
$30K |
| L3485 |
Shoe heel pad removable for |
1,266 |
634 |
$9K |
| L3219 |
Orthopedic mens shoes oxford |
134 |
68 |
$5K |
| L3215 |
Orthopedic ftwear ladies oxf |
112 |
56 |
$4K |
| L3360 |
Shoe sole wedge outside sole |
178 |
89 |
$3K |
| L2755 |
Carbon graphite lamination |
26 |
13 |
$2K |