| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0935 |
Continuous passive motion exercise device for use on knee only |
79 |
14 |
$2K |
| 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 |
34 |
13 |
$661.22 |
| 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 |
32 |
12 |
$496.52 |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
170 |
121 |
$186.00 |