| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L6624 |
Flex/ext/rotation wrist unit |
98 |
64 |
$4K |
| L6205 |
Elbow molded w/ expand inter |
93 |
47 |
$2K |
| L1690 |
Combination bilateral ho |
48 |
44 |
$2K |
| L0710 |
Ctlso a-p-l control w/ inter |
50 |
46 |
$1K |
| L3904 |
Whfo electric custom fitted |
86 |
44 |
$1K |
| L3730 |
Forearm/arm cuffs ext/flex a |
93 |
47 |
$698.28 |
| L3978 |
Sewhfo airplane w/jnt(s) cf |
89 |
57 |
$0.00 |
| L0170 |
Cervical collar molded to pt |
51 |
47 |
$0.00 |
| L2005 |
Kafo sng/dbl mechanical act |
86 |
56 |
$0.00 |
| L1005 |
Tension based scoliosis orth |
51 |
49 |
$0.00 |
| L0636 |
Lso sagittal rigid panel cus |
45 |
43 |
$0.00 |
| L0830 |
Halo cerv into milwaukee typ |
53 |
49 |
$0.00 |
| L1833 |
Ko adj jnt pos r sup pre ots |
85 |
57 |
$0.00 |
| L1710 |
Legg perthes orth newington |
90 |
46 |
$0.00 |