| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
1,927 |
1,070 |
$730K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,588 |
818 |
$133K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
2,795 |
1,412 |
$106K |
| L1940 |
Ankle foot orthosis, plastic or other material, custom fabricated |
248 |
135 |
$81K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
840 |
392 |
$26K |
| L3040 |
Foot, arch support, removable, premolded, longitudinal, each |
1,356 |
708 |
$24K |
| L0984 |
Protective body sock, prefabricated, off-the-shelf, each |
217 |
185 |
$22K |
| L1200 |
Thoracic-lumbar-sacral-orthosis (tlso), inclusive of furnishing initial orthosis only |
14 |
13 |
$9K |
| L1210 |
Addition to tlso, (low profile), lateral thoracic extension |
58 |
53 |
$9K |
| A4467 |
Belt, strap, sleeve, garment, or covering, any type |
95 |
50 |
$4K |
| L1290 |
Addition to tlso, (low profile), lateral trochanteric pad |
68 |
61 |
$4K |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
24 |
12 |
$4K |
| L4396 |
Static or dynamic ankle foot orthosis, including soft interface material, adjustable for fit, for positioning, may be used for minimal ambulation, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
25 |
15 |
$3K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
165 |
74 |
$2K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
22 |
13 |
$2K |
| L1060 |
Addition to ctlso or scoliosis orthosis, thoracic pad |
31 |
26 |
$2K |
| L3260 |
Surgical boot/shoe, each |
93 |
51 |
$1K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
49 |
25 |
$1K |
| L1240 |
Addition to tlso, (low profile), lumbar derotation pad |
12 |
12 |
$544.92 |