| 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 |
1,946 |
1,148 |
$102K |
| 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 |
1,584 |
918 |
$96K |
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
30 |
26 |
$6K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
34 |
30 |
$3K |
| E0100 |
Cane, includes canes of all materials, adjustable or fixed, with tip |
70 |
70 |
$943.16 |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
23 |
12 |
$478.48 |