L8002 Brst prsth bra & bilat form
ANEST_BU
0
BETOS
D1F
Long Description
Breast prosthesis, mastectomy bra, with integrated breast prosthesis form, bilateral, any size, any type
Category
COV
D
HCPCS
L8002
MULT_PI
A
PRICE1
38.00
RECID
3
SEQNUM
0010
SHORT DESCRIPTION
Brst prsth bra & bilat form
TOS1
P