| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 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 |
85 |
43 |
$8K |
| L0651 |
Lumbar-sacral orthosis, sagittal-coronal control, rigid shell(s)/panel(s), posterior extends from sacrococcygeal junction to t-9 vertebra, anterior extends from symphysis pubis to xyphoid, produces intracavitary pressure to reduce load on the intervertebral discs, overall strength is provided by overlapping rigid material and stabilizing closures, includes straps, closures, may include soft interface, pendulous abdomen design, prefabricated, off-the-shelf |
63 |
59 |
$8K |
| L2397 |
Addition to lower extremity orthosis, suspension sleeve |
86 |
43 |
$877.50 |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
49 |
41 |
$68.90 |
| L3916 |
Wrist hand orthosis, includes one or more nontorsion joint(s), elastic bands, turnbuckles, may include soft interface, straps, prefabricated, off-the-shelf |
24 |
12 |
$0.00 |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
17 |
14 |
$0.00 |