| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L0637 |
Lumbar-sacral orthosis, sagittal-coronal control, with rigid anterior and posterior frame/panels, posterior extends from sacrococcygeal junction to t-9 vertebra, lateral strength provided by rigid lateral frame/panels, produces intracavitary pressure to reduce load on intervertebral discs, includes straps, closures, may include padding, shoulder straps, pendulous abdomen design, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
306 |
305 |
$272K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
2,255 |
2,249 |
$198K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
3,021 |
2,857 |
$139K |
| 99205 |
Prolong outpt/office vis |
329 |
328 |
$34K |
| 99215 |
Prolong outpt/office vis |
442 |
429 |
$32K |
| 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 |
17 |
16 |
$3K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
18 |
17 |
$641.52 |
| 98960 |
|
36 |
36 |
$0.00 |