Splints & Casts Payment limit
| Code | Payment Limit |
| Q4004 | $110.92 |
| Q4005 | $11.81 |
| Q4006 | $26.62 |
| Q4007 | $5.92 |
| Q4008 | $13.31 |
| Q4009 | $7.89 |
| Q4010 | $17.75 |
| Q4011 | $3.94 |
| Q4012 | $8.88 |
| Q4013 | $14.36 |
| Q4014 | $24.21 |
| Q4015 | $7.18 |
| Q4016 | $12.10 |
| Q4017 | $8.30 |
| Q4018 | $13.23 |
| Q4019 | $4.16 |
| Q4020 | $6.62 |
| Q4021 | $6.14 |
| Q4022 | $11.08 |
| Q4023 | $3.09 |
| Q4024 | $5.54 |
| Q4025 | $34.44 |
| Q4026 | $107.54 |
| Q4027 | $17.23 |
| Q4028 | $53.78 |
| Q4029 | $26.34 |
| Q4030 | $69.33 |
| Q4031 | $13.17 |
| Q4032 | $34.66 |
| Q4033 | $24.57 |
| Q4034 | $61.10 |
| Q4035 | $12.28 |
| Q4036 | $30.56 |
| Q4037 | $14.99 |
| Q4038 | $37.55 |
| Q4039 | $7.51 |
| Q4040 | $18.76 |
| Q4041 | $18.22 |
| Q4042 | $31.11 |
| Q4043 | $9.12 |
| Q4044 | $15.56 |
| Q4045 | $10.58 |
| Q4046 | $17.02 |
| Q4047 | $5.28 |
| Q4048 | $8.51 |
| Q4049 | $1.93 |
