| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| K1005 |
Disp col sto bag breast milk |
89,825 |
54,777 |
$3.60M |
| E0603 |
Electric breast pump |
16,713 |
15,042 |
$3.37M |
| A4287 |
Disp col sto bag breast milk |
44,680 |
25,733 |
$1.62M |
| L2630 |
Pelvic control band & belt u |
6,462 |
6,304 |
$1.52M |
| E0604 |
Hosp grade elec breast pump |
5,792 |
5,639 |
$301K |
| S9445 |
Pt education noc individ |
3,435 |
3,430 |
$209K |
| L0621 |
Sio flex pelvic/sacr pre ots |
847 |
805 |
$62K |
| E1399 |
Durable medical equipment mi |
982 |
957 |
$42K |
| A4284 |
Replcmnt breast pump shield |
3,878 |
2,966 |
$37K |
| A7000 |
Disposable canister for pump |
4,175 |
3,979 |
$35K |
| A7002 |
Tubing used w suction pump |
3,556 |
3,384 |
$17K |
| A4282 |
Replacement breastpump adpt |
1,285 |
1,192 |
$6K |
| A4281 |
Replacement breastpump tube |
636 |
611 |
$6K |
| A4283 |
Replacement breastpump cap |
609 |
594 |
$4K |
| A6530 |
Compression stocking bk18-30 |
26 |
13 |
$688.20 |
| A4285 |
Replcmnt breast pump bottle |
108 |
107 |
$3.25 |
| A9900 |
Supply/accessory/service |
61 |
61 |
$0.00 |