| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1970 |
Ankle foot orthosis, plastic with ankle joint, custom fabricated |
70 |
41 |
$42K |
| K0823 |
Power wheelchair, group 2 standard, captains chair, patient weight capacity up to and including 300 pounds |
252 |
178 |
$22K |
| 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 |
1,246 |
562 |
$19K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
222 |
113 |
$11K |
| L2840 |
Addition to lower extremity orthosis, tibial length sock, fracture or equal, each |
298 |
149 |
$9K |
| L1960 |
Ankle foot orthosis, posterior solid ankle, plastic, custom fabricated |
20 |
12 |
$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 |
149 |
93 |
$4K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
46 |
29 |
$4K |
| L2200 |
Addition to lower extremity, limited ankle motion, each joint |
25 |
12 |
$840.27 |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, 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 |
23 |
12 |
$679.18 |