| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L3020 |
Foot, insert, removable, molded to patient model, longitudinal/ metatarsal support, each |
149 |
132 |
$45K |
| L3002 |
Foot, insert, removable, molded to patient model, plastazote or equal, each |
88 |
82 |
$24K |
| 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 |
252 |
96 |
$15K |
| 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 |
273 |
134 |
$12K |