| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
2,155 |
1,939 |
$280K |
| L3984 |
Upper extremity fracture orthosis, wrist, prefabricated, includes fitting and adjustment |
1,240 |
1,101 |
$210K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
614 |
579 |
$179K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
693 |
570 |
$52K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
2,557 |
2,283 |
$47K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
517 |
452 |
$47K |
| L1812 |
Knee orthosis, elastic with joints, prefabricated, off-the-shelf |
535 |
448 |
$23K |
| L3660 |
Shoulder orthosis, figure of eight design abduction restrainer, canvas and webbing, prefabricated, off-the-shelf |
579 |
510 |
$16K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
886 |
870 |
$15K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
536 |
463 |
$15K |
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
226 |
209 |
$11K |
| L2795 |
Addition to lower extremity orthosis, knee control, full kneecap |
349 |
312 |
$10K |
| L3260 |
Surgical boot/shoe, each |
163 |
159 |
$3K |
| L1830 |
Knee orthosis, immobilizer, canvas longitudinal, prefabricated, off-the-shelf |
41 |
41 |
$2K |
| L1821 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, off the shelf |
12 |
12 |
$1K |
| A4467 |
Belt, strap, sleeve, garment, or covering, any type |
16 |
13 |
$361.00 |
| A9270 |
Non-covered item or service |
15 |
12 |
$320.00 |