| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
690 |
407 |
$73K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
834 |
546 |
$64K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
42 |
42 |
$12K |
| E0570 |
Nebulizer, with compressor |
139 |
139 |
$8K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
106 |
92 |
$8K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
139 |
139 |
$2K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
12 |
12 |
$1K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
54 |
27 |
$1K |
| S8101 |
Holding chamber or spacer for use with an inhaler or nebulizer; with mask |
138 |
138 |
$527.26 |