| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L4361 |
Walking boot, pneumatic and/or vacuum, with or without joints, with or without interface material, prefabricated, off-the-shelf |
79 |
72 |
$7K |
| 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 |
54 |
50 |
$5K |
| L1833 |
Knee orthosis, adjustable knee joints (unicentric or polycentric), positional orthosis, rigid support, prefabricated, off-the shelf |
64 |
43 |
$3K |
| L3916 |
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
39 |
39 |
$2K |
| L3960 |
Shoulder elbow wrist hand orthosis, abduction positioning, airplane design, prefabricated, includes fitting and adjustment |
46 |
39 |
$1K |
| 97760 |
|
165 |
153 |
$1K |
| L1902 |
Ankle orthosis, ankle gauntlet or similar, with or without joints, prefabricated, off-the-shelf |
15 |
14 |
$591.63 |
| E0114 |
Crutches underarm, other than wood, adjustable or fixed, pair, with pads, tips and handgrips |
15 |
13 |
$445.51 |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
63 |
42 |
$364.63 |
| E0676 |
Intermittent limb compression device (includes all accessories), not otherwise specified |
494 |
482 |
$0.00 |