| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2275 |
Plastic mod low ext pad/line |
1,981 |
1,143 |
$192K |
| L2820 |
Soft interface below knee se |
1,014 |
650 |
$64K |
| L2270 |
Varus/valgus strap padded/li |
1,500 |
835 |
$60K |
| L2280 |
Molded inner boot |
156 |
81 |
$51K |
| L1907 |
Afo supramalleolar custom |
74 |
43 |
$33K |
| L1970 |
Afo plastic molded w/ankle j |
77 |
52 |
$33K |
| A5500 |
Diab shoe for density insert |
456 |
260 |
$17K |
| L3670 |
So acro/clav can web pre ots |
155 |
154 |
$13K |
| L1960 |
Afo pos solid ank plastic mo |
22 |
12 |
$10K |
| E0114 |
Crutch underarm pair no wood |
168 |
166 |
$6K |
| A5513 |
Multi den insert custom mold |
26 |
12 |
$2K |
| L3908 |
Who cock-up nonmolde pre ots |
28 |
28 |
$1K |