| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3430 |
Heel, counter, plastic reinforced |
866 |
395 |
$79K |
| L1907 |
Ankle orthosis, supramalleolar with straps, with or without interface/pads, custom fabricated |
90 |
38 |
$21K |
| L2280 |
Addition to lower extremity, molded inner boot |
114 |
52 |
$21K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
183 |
84 |
$10K |
| L3390 |
Outflare wedge |
150 |
62 |
$4K |
| L2270 |
Addition to lower extremity, varus/valgus correction ('t') strap, padded/lined or malleolus pad |
163 |
72 |
$4K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
78 |
44 |
$3K |
| L3334 |
Lift, elevation, heel, per inch |
92 |
44 |
$2K |
| L3206 |
Orthopedic shoe, hightop with supinator or pronator, child |
30 |
13 |
$1K |
| 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 |
28 |
13 |
$902.26 |
| 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 |
27 |
13 |
$808.38 |