| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
393 |
354 |
$55K |
| A6539 |
Gradient compression stocking, waist length, 18-30 mmhg, each |
13 |
12 |
$4K |
| A6533 |
Gradient compression stocking, thigh length, 18-30 mmhg, each |
13 |
13 |
$3K |
| A6531 |
Gradient compression stocking, below knee, 30-40 mmhg, used as a surgical dressing, each |
21 |
12 |
$2K |
| L8000 |
Breast prosthesis, mastectomy bra, without integrated breast prosthesis form, any size, any type |
21 |
12 |
$458.15 |