| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
9,930 |
5,030 |
$1.45M |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
7,260 |
4,068 |
$433K |
| L3221 |
Orthopedic footwear, mens shoe, depth inlay, each |
5,622 |
3,460 |
$351K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
972 |
478 |
$128K |
| E0603 |
Breast pump, electric (ac and/or dc), any type |
972 |
951 |
$128K |
| A6540 |
Gradient compression stocking, waist length, 30-40 mmhg, each |
608 |
321 |
$98K |
| L3030 |
Foot, insert, removable, formed to patient foot, each |
2,370 |
1,793 |
$88K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
1,162 |
577 |
$61K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
838 |
409 |
$45K |
| L0622 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated |
264 |
256 |
$33K |
| L3203 |
Orthopedic shoe, oxford with supinator or pronator, junior |
584 |
292 |
$25K |
| 97760 |
|
2,189 |
2,188 |
$9K |
| L8310 |
Truss, double with standard pads |
114 |
106 |
$9K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
76 |
70 |
$6K |
| 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 |
278 |
125 |
$1K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
293 |
135 |
$958.42 |