| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0604 |
Hosp grade elec breast pump |
1,018 |
985 |
$66K |
| E0601 |
Cont airway pressure device |
1,018 |
959 |
$40K |
| A4604 |
Tubing with heating element |
453 |
425 |
$19K |
| E0562 |
Humidifier heated used w pap |
1,130 |
1,058 |
$19K |
| A7031 |
Replacement facemask interfa |
553 |
512 |
$15K |
| A7030 |
Cpap full face mask |
112 |
107 |
$8K |
| A7035 |
Pos airway press headgear |
370 |
352 |
$6K |
| A7034 |
Nasal application device |
52 |
52 |
$3K |
| A4407 |
Ext wear ost skn barr <=4sq" |
14 |
14 |
$2K |
| A7038 |
Pos airway pressure filter |
563 |
423 |
$2K |
| A5120 |
Skin barrier, wipe or swab |
136 |
129 |
$1K |
| A7046 |
Repl water chamber, pap dev |
69 |
67 |
$715.61 |
| A7033 |
Replacement nasal pillows |
12 |
12 |
$444.87 |
| A6402 |
Sterile gauze <= 16 sq in |
35 |
25 |
$166.54 |