| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1005 |
Tension based scoliosis orthosis and accessory pads, includes fitting and adjustment |
102 |
99 |
$17K |
| L0174 |
Cervical, collar, semi-rigid, thermoplastic foam, two piece with thoracic extension, prefabricated, off-the-shelf |
26 |
26 |
$51.47 |
| L1686 |
Hip orthosis, abduction control of hip joint, postoperative hip abduction type, prefabricated, includes fitting and adjustment |
20 |
19 |
$0.00 |
| L1852 |
Knee orthosis (ko), double upright, thigh and calf, with adjustable flexion and extension joint (unicentric or polycentric), medial-lateral and rotation control, with or without varus/valgus adjustment, prefabricated, off-the-shelf |
18 |
17 |
$0.00 |