FOOTWEAR AND RELATED ACCESSORIES - CUSTOM BUILT SHOES

FOOTWEAR AND RELATED ACCESSORIES - CUSTOM BUILT SHOES

Benefit Code Number
503713
Program of Choice
11 - Prosthetics and orthotics
Province
Alberta
Prescriber Required
Physiatrist
Othropedic Surgeon
Medical Doctor
Recommender Required
No
Preauthorization Required
Yes
Limit
$2,500.00
Frequency
1 PAIR/1 CY
Provincial Coverage
No
Comments
SEE NOTE 1, SEE NOTE 6
Notes
GENERAL NOTES COMMAS APPEARING IN THE "PRESCRIBER REQUIRED" AND "RECOMMENDER REQUIRED" COLUMNS INDICATE OR, EG. "MD", "RN" MEANS "MD" OR "RN". SPECIAL NOTES