| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
125 |
66 |
$19K |
| 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 |
196 |
112 |
$8K |
| 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 |
132 |
79 |
$7K |
| A4670 |
Automatic blood pressure monitor |
299 |
202 |
$4K |
| A4663 |
Blood pressure cuff only |
53 |
19 |
$0.00 |