| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L0648 |
Lumbar-sacral orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from sacrococcygeal junction to t-9 vertebra, produces intracavitary pressure to reduce load on the intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
2,628 |
2,472 |
$959K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
3,010 |
1,987 |
$682K |
| L3960 |
Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
1,835 |
1,557 |
$666K |
| E0570 |
Nebulizer, with compressor |
6,485 |
6,280 |
$449K |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
1,812 |
1,297 |
$402K |
| E0745 |
Neuromuscular stimulator, electronic shock unit |
1,222 |
1,144 |
$265K |
| L3809 |
Wrist hand finger orthosis, without joint(s), prefabricated, off-the-shelf, any type |
2,632 |
1,823 |
$223K |
| L0174 |
Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf |
1,614 |
1,511 |
$161K |
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
888 |
867 |
$135K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
2,822 |
1,890 |
$122K |
| L1660 |
Hip orthosis, abduction control of hip joints, static, plastic, prefabricated, includes fitting and adjustment |
675 |
534 |
$59K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
6,269 |
6,062 |
$55K |
| A6531 |
Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each |
842 |
776 |
$52K |
| E0730 |
Transcutaneous electrical nerve stimulation (tens) device, four or more leads, for multiple nerve stimulation |
646 |
590 |
$37K |
| L3908 |
Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf |
862 |
787 |
$30K |
| L3762 |
Elbow orthosis, rigid, without joints, includes soft interface material, prefabricated, off-the-shelf |
719 |
544 |
$22K |
| L3710 |
Elbow orthosis, elastic with metal joints, prefabricated, off-the-shelf |
420 |
300 |
$22K |
| T4524 |
Adult sized disposable incontinence product, brief/diaper, extra large, each |
147 |
146 |
$13K |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
2,097 |
1,936 |
$12K |
| A7015 |
Aerosol mask, used with dme nebulizer |
6,265 |
6,060 |
$6K |
| A4554 |
Disposable underpads, all sizes |
191 |
190 |
$6K |
| A4557 |
Lead wires, (e.g., apnea monitor), per pair |
900 |
781 |
$4K |
| A4670 |
Automatic blood pressure monitor |
127 |
119 |
$4K |
| L4387 |
Walking boot, non-pneumatic, with or without joints, with or without interface material, prefabricated, off-the-shelf |
40 |
40 |
$4K |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
65 |
64 |
$2K |
| L3216 |
Orthopedic footwear, ladies shoe, depth inlay, each |
24 |
12 |
$1K |
| A4927 |
Gloves, non-sterile, per 100 |
184 |
183 |
$1K |