| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
408 |
181 |
$16K |
| L3060 |
Foot, arch support, removable, premolded, longitudinal/ metatarsal, each |
203 |
90 |
$11K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
54 |
29 |
$9K |
| 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 |
88 |
38 |
$1K |