| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Breast pump, electric (ac and/or dc), any type |
562 |
477 |
$59K |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
586 |
428 |
$12K |
| E0601 |
Continuous positive airway pressure (cpap) device |
109 |
97 |
$2K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
97 |
82 |
$691.84 |
| A6446 |
Conforming bandage, non-elastic, knitted/woven, sterile, width greater than or equal to three inches and less than five inches, per yard |
34 |
24 |
$366.85 |
| A6402 |
Gauze, non-impregnated, sterile, pad size 16 sq. in. or less, without adhesive border, each dressing |
77 |
55 |
$287.28 |
| K0001 |
Standard wheelchair |
18 |
12 |
$283.56 |
| A4452 |
Tape, waterproof, per 18 square inches |
20 |
14 |
$117.73 |
| A4216 |
Sterile water, saline and/or dextrose, diluent/flush, 10 ml |
24 |
14 |
$62.57 |