| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0651 |
Pneumatic compressor, segmental home model without calibrated gradient pressure |
103 |
103 |
$61K |
| E0667 |
Segmental pneumatic appliance for use with pneumatic compressor, full leg |
153 |
129 |
$51K |
| L3916 |
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
12 |
12 |
$6K |
| L0650 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panel(s), produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated, off-the-shelf |
12 |
12 |
$1K |