| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
101 |
49 |
$7K |
| L4205 |
Repair of orthotic device, labor component, per 15 minutes |
221 |
178 |
$6K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
25 |
13 |
$5K |
| L4002 |
Replacement strap, any orthosis, includes all components, any length, any type |
34 |
26 |
$1K |
| L4210 |
Repair of orthotic device, repair or replace minor parts |
17 |
13 |
$125.05 |