Description - DE Medical Assistance Program

L1971 AFO W/ANKLE JOINT, PREFAB 6 $0.00
L1980 AFO SING SOLID STIRRUP CALF 3 $263.51
L1990 AFO DOUB SOLID STIRRUP CALF 3 $320.05
L2000 KAFO SING FRE STIRR THI/CALF 3 $758.23
L2005 KAFO SNG/DBL MECHANICAL ACT 6 $0.00
L2010 KAFO SNG SOLID STIRRUP W/O J 3 $707.32
L2020 KAFO DBL SOLID STIRRUP BAND/ 3 $890.63
L2030 KAFO DBL SOLID STIRRUP W/O J 3 $808.48
L2034 KAFO PLA SIN UP W/WO K/A CUS 6 $0.00
L2035 KAFO PLASTIC PEDIATRIC SIZE 3 $131.14
L2036 KAFO PLAS DOUB FREE KNEE MOL 3 $1,380.47
L2037 KAFO PLAS SING FREE KNEE MOL 3 $1,287.91
L2038 KAFO W/O JOINT MULTI-AXIS AN 3 $1,308.30
L2039 KAFO,PLSTIC,MEDLAT ROTAT CON O $0.00
L2040 HKAFO TORSION BIL ROT STRAPS 3 $158.68
L2050 HKAFO TORSION CABLE HIP PELV 3 $342.03
L2060 HKAFO TORSION BALL BEARING J 3 $416.86
L2070 HKAFO TORSION UNILAT ROT STR 3 $107.04
L2080 HKAFO UNILAT TORSION CABLE 3 $258.25
L2090 HKAFO UNILAT TORSION BALL BR 3 $314.84
L2102 AFO TIBIAL FX CAST PLSTR MOL O $0.00
L2104 AFO TIB FX CAST SYNTHETIC MO O $0.00
L2106 AFO TIB FX CAST PLASTER MOLD 3 $488.18
L2108 AFO TIB FX CAST MOLDED TO PT 3 $850.00
L2112 AFO TIBIAL FRACTURE SOFT 3 $390.97
L2114 AFO TIB FX SEMI-RIGID 3 $490.39
L2116 AFO TIBIAL FRACTURE RIGID 3 $564.23
L2122 KAFO FEM FX CAST PLASTER MOL O $0.00
L2124 KAFO FEM FX CAST SYNTHET MOL O $0.00
L2126 KAFO FEM FX CAST THERMOPLAS 3 $943.82
L2128 KAFO FEM FX CAST MOLDED TO P 3 $1,336.53
L2132 KAFO FEMORAL FX CAST SOFT 3 $724.60
L2134 KAFO FEM FX CAST SEMI-RIGID 3 $773.23
L2136 KAFO FEMORAL FX CAST RIGID 3 $922.89
L2180 PLAS SHOE INSERT W ANK JOINT 3 $86.13
L2182 DROP LOCK KNEE 3 $71.37
L2184 LIMITED MOTION KNEE JOINT 3 $97.56
L2186 ADJ MOTION KNEE JNT LERMAN T 3 $135.31
L2188 QUADRILATERAL BRIM 3 $259.14
L2190 WAIST BELT 3 $66.96
L2192 PELVIC BAND & BELT THIGH FLA 3 $294.02
L2200 LIMITED ANKLE MOTION EA JNT 3 $34.14
L2210 DORSIFLEXION ASSIST EACH JOI 3 $49.41
L2220 DORSI & PLANTAR FLEX ASS/RES 3 $58.80
L2230 SPLIT FLAT CALIPER STIRR & P 3 $55.09
L2232 ROCKER BOTTOM, CONTACT AFO 6 $0.00
L2240 ROUND CALIPER AND PLATE ATTA 3 $68.19
L2250 FOOT PLATE MOLDED STIRRUP AT 3 $276.47
L2260 REINFORCED SOLID STIRRUP 3 $143.93