| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6549 |
Gradient compression garment, not otherwise specified, for daytime use, each |
239 |
182 |
$257K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
334 |
243 |
$23K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
171 |
135 |
$19K |
| A6593 |
Accessory for gradient compression garment or wrap with adjustable straps, not-otherwise specified |
227 |
107 |
$16K |
| 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 |
227 |
176 |
$10K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
21 |
19 |
$6K |
| A6583 |
Gradient compression wrap with adjustable straps, below knee, each |
127 |
77 |
$6K |
| 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 |
58 |
49 |
$4K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
27 |
25 |
$2K |
| A6545 |
Gradient compression wrap, non-elastic, below knee, 30-50 mmhg, used as a surgical dressing, each |
28 |
12 |
$2K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
12 |
12 |
$695.95 |
| 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 |
17 |
13 |
$675.07 |
| L2820 |
Addition to lower extremity orthosis, soft interface for molded plastic, below knee section |
12 |
12 |
$498.80 |