| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, 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 |
1,647 |
842 |
$123K |
| L3010 |
Foot, insert, removable, molded to patient model, longitudinal arch support, each |
750 |
650 |
$110K |
| 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 |
1,909 |
1,069 |
$64K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
126 |
106 |
$10K |
| 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 |
70 |
57 |
$10K |