| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| T2028 |
Specialized supply, not otherwise specified, waiver |
310 |
299 |
$627K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
3,839 |
1,859 |
$257K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
1,858 |
933 |
$124K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
2,248 |
1,126 |
$85K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
831 |
805 |
$53K |
| L2280 |
Addition to lower extremity, molded inner boot |
202 |
103 |
$45K |
| T1999 |
Miscellaneous therapeutic items and supplies, retail purchases, not otherwise classified; identify product in "remarks" |
12 |
12 |
$24K |
| L1945 |
Ankle foot orthosis, plastic, rigid anterior tibial section (floor reaction), custom fabricated |
24 |
12 |
$17K |
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
67 |
37 |
$15K |
| L4210 |
Repair of orthotic device, repair or replace minor parts |
329 |
321 |
$14K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
24 |
13 |
$5K |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
30 |
14 |
$3K |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
68 |
37 |
$2K |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
53 |
50 |
$2K |