| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
217 |
95 |
$5K |
| L1845 |
Knee orthosis, double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
73 |
13 |
$3K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
66 |
29 |
$1K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
37 |
18 |
$850.64 |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
25 |
13 |
$793.47 |
| E0156 |
Seat attachment, walker |
37 |
18 |
$251.26 |