| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
1,456 |
930 |
$159K |
| 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 |
736 |
348 |
$29K |
| L3000 |
Foot, insert, removable, molded to patient model, 'ucb' type, berkeley shell, each |
116 |
66 |
$27K |
| 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 |
975 |
466 |
$23K |
| L3202 |
Orthopedic shoe, oxford with supinator or pronator, child |
421 |
255 |
$20K |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
197 |
129 |
$7K |