| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
170 |
169 |
$17K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
227 |
205 |
$10K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
107 |
106 |
$3K |
| 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 |
25 |
24 |
$2K |
| L2275 |
Addition to lower extremity, varus/valgus correction, plastic modification, padded/lined |
21 |
12 |
$2K |
| L3670 |
Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf |
13 |
13 |
$751.24 |