| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L1820 |
Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise |
189 |
109 |
$2K |
| L3761 |
Elbow orthosis (eo), with adjustable position locking joint(s), prefabricated, off-the-shelf |
32 |
32 |
$644.42 |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
14 |
14 |
$557.75 |
| L0627 |
Lumbar orthosis, sagittal control, with rigid anterior and posterior panels, posterior extends from l-1 to below l-5 vertebra, produces intracavitary pressure to reduce load on the 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 |
33 |
33 |
$73.85 |
| L2387 |
Addition to lower extremity, polycentric knee joint, for custom fabricated knee ankle foot orthosis, each joint |
177 |
97 |
$20.67 |
| L0180 |
Cervical, multiple post collar, occipital/mandibular supports, adjustable |
19 |
19 |
$0.00 |
| L1971 |
Ankle foot orthosis, plastic or other material with ankle joint, with or without dorsiflexion assist, prefabricated, includes fitting and adjustment |
37 |
19 |
$0.00 |