| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3000 |
Ft insert ucb berkeley shell |
3,331 |
1,967 |
$476K |
| 99213 |
|
7,294 |
7,120 |
$433K |
| L3332 |
Shoe lifts tapered to one-ha |
4,557 |
4,518 |
$360K |
| 99214 |
|
3,205 |
3,167 |
$301K |
| 99204 |
|
2,292 |
2,286 |
$289K |
| L2820 |
Soft interface below knee se |
2,708 |
2,679 |
$225K |
| L2275 |
Plastic mod low ext pad/line |
2,183 |
2,026 |
$224K |
| L3020 |
Foot longitud/metatarsal sup |
1,179 |
629 |
$196K |
| 29405 |
|
2,859 |
1,907 |
$170K |
| L3060 |
Foot arch supp longitud/meta |
3,280 |
1,762 |
$154K |
| L3350 |
Shoe heel wedge |
4,169 |
4,126 |
$103K |
| 99212 |
|
1,778 |
1,745 |
$71K |
| L1930 |
Afo plastic |
531 |
317 |
$67K |
| L3390 |
Shoe outflare wedge |
861 |
857 |
$55K |
| L1836 |
Ko rigid w/o joints pre ots |
558 |
330 |
$35K |
| L3410 |
Shoe metatarsal bar between |
275 |
270 |
$33K |
| L3370 |
Shoe sole wedge between sole |
526 |
520 |
$32K |
| L2830 |
Soft interface above knee se |
272 |
271 |
$24K |
| 29540 |
|
938 |
630 |
$21K |
| L3510 |
Orthopedic shoe add rub insl |
989 |
921 |
$15K |
| Q4037 |
Cast sup shrt leg plaster |
823 |
823 |
$11K |
| L3500 |
Ortho shoe add leather insol |
716 |
647 |
$11K |
| 99203 |
|
82 |
82 |
$7K |
| Q4039 |
Cast sup shrt leg ped plster |
587 |
582 |
$7K |
| L3010 |
Foot longitudinal arch suppo |
42 |
21 |
$6K |
| 99205 |
Prolong outpt/office vis |
22 |
22 |
$4K |
| L3360 |
Shoe sole wedge outside sole |
67 |
66 |
$3K |
| L3430 |
Sho heel count plast reinfor |
13 |
13 |
$3K |
| 97763 |
|
181 |
166 |
$2K |
| L3480 |
Shoe heel pad & depress for |
26 |
26 |
$2K |
| 99215 |
Prolong outpt/office vis |
12 |
12 |
$1K |
| 97760 |
|
97 |
90 |
$707.38 |
| 11721 |
|
12 |
12 |
$403.08 |