L4055 Replace non-molded calf lace
ANEST_BU
0
BETOS
D1F
Long Description
Replace non-molded calf lacer, for custom fabricated orthosis only
Category
COV
C
HCPCS
L4055
MULT_PI
A
PRICE1
38.00
RECID
3
SEQNUM
0010
SHORT DESCRIPTION
Replace non-molded calf lace
TOS1
P