| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L5673 |
Addition to lower extremity, below knee/above knee, custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism |
13 |
12 |
$3K |
| L5671 |
Addition to lower extremity, below knee / above knee suspension locking mechanism (shuttle, lanyard or equal), excludes socket insert |
13 |
12 |
$3K |
| L3807 |
Wrist hand finger orthosis, without joint(s), prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
19 |
12 |
$838.05 |
| L1930 |
Ankle foot orthosis, plastic or other material, prefabricated, includes fitting and adjustment |
25 |
13 |
$0.00 |