| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
2,872 |
2,842 |
$363K |
| E1390 |
Oxygen concentrator |
2,534 |
2,519 |
$250K |
| E0431 |
Portable gaseous 02 |
2,088 |
2,076 |
$44K |
| E0570 |
Nebulizer with compression |
805 |
802 |
$28K |
| A6403 |
Sterile gauze>16 <= 48 sq in |
664 |
486 |
$9K |
| A6446 |
Conform band s w>=3" <5"/yd |
845 |
592 |
$9K |
| E0143 |
Walker folding wheeled w/o s |
143 |
141 |
$8K |
| S5161 |
Emer rspns sys serv permonth |
212 |
212 |
$4K |
| E0601 |
Cont airway pressure device |
46 |
46 |
$4K |
| A4450 |
Non-waterproof tape |
937 |
702 |
$3K |
| A6260 |
Wound cleanser any type/size |
433 |
399 |
$2K |
| A7030 |
Cpap full face mask |
16 |
16 |
$1K |
| E0562 |
Humidifier heated used w pap |
51 |
51 |
$706.51 |
| A7037 |
Pos airway pressure tubing |
45 |
45 |
$647.27 |
| A7035 |
Pos airway press headgear |
12 |
12 |
$296.00 |
| A7038 |
Pos airway pressure filter |
82 |
81 |
$264.93 |
| A7046 |
Repl water chamber, pap dev |
12 |
12 |
$90.82 |
| A6216 |
Non-sterile gauze<=16 sq in |
12 |
12 |
$84.50 |
| A7015 |
Aerosol mask used w nebulize |
25 |
25 |
$25.89 |
| A7003 |
Nebulizer administration set |
12 |
12 |
$19.36 |