| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
1,512 |
1,406 |
$346K |
| E0601 |
Cont airway pressure device |
5,047 |
4,819 |
$253K |
| A4604 |
Tubing with heating element |
1,066 |
1,016 |
$34K |
| A7030 |
Cpap full face mask |
193 |
181 |
$19K |
| A7034 |
Nasal application device |
293 |
285 |
$16K |
| A7035 |
Pos airway press headgear |
835 |
793 |
$15K |
| E0604 |
Hosp grade elec breast pump |
287 |
261 |
$9K |
| A7038 |
Pos airway pressure filter |
1,764 |
1,069 |
$7K |
| A7039 |
Filter, non disposable w pap |
372 |
352 |
$2K |
| E0114 |
Crutch underarm pair no wood |
52 |
51 |
$2K |
| A7046 |
Repl water chamber, pap dev |
82 |
80 |
$472.89 |