| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| L0622 |
Sacroiliac orthosis, flexible, provides pelvic-sacral support, reduces motion about the sacroiliac joint, includes straps, closures, may include pendulous abdomen design, custom fabricated |
924 |
858 |
$115K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
233 |
203 |
$16K |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
185 |
146 |
$12K |
| L8030 |
Breast prosthesis, silicone or equal, without integral adhesive |
15 |
15 |
$7K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
86 |
74 |
$4K |