| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6533 |
Gc stocking thighlngth 18-30 |
4,063 |
3,121 |
$396K |
| A5500 |
Diab shoe for density insert |
4,615 |
2,326 |
$261K |
| A6530 |
Compression stocking bk18-30 |
2,064 |
1,578 |
$140K |
| A5512 |
Multi den insert direct form |
2,004 |
979 |
$50K |
| A5513 |
Multi den insert custom mold |
1,069 |
481 |
$39K |
| L1820 |
Ko elas w/ condyle pads & jo |
161 |
119 |
$15K |
| L3010 |
Foot longitudinal arch suppo |
85 |
44 |
$14K |
| L3020 |
Foot longitud/metatarsal sup |
71 |
37 |
$14K |
| L3000 |
Ft insert ucb berkeley shell |
25 |
13 |
$8K |
| A6539 |
Gc stocking waistlngth 18-30 |
57 |
55 |
$6K |