| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0603 |
Electric breast pump |
1,518 |
1,405 |
$296K |
| E0601 |
Cont airway pressure device |
3,556 |
3,463 |
$159K |
| A4604 |
Tubing with heating element |
2,179 |
2,155 |
$99K |
| A7034 |
Nasal application device |
921 |
912 |
$67K |
| A7035 |
Pos airway press headgear |
2,081 |
2,049 |
$49K |
| A7030 |
Cpap full face mask |
317 |
316 |
$32K |
| A7031 |
Replacement facemask interfa |
753 |
746 |
$32K |
| A7032 |
Replacement nasal cushion |
612 |
609 |
$29K |
| A7046 |
Repl water chamber, pap dev |
944 |
937 |
$14K |
| A7038 |
Pos airway pressure filter |
3,808 |
3,767 |
$10K |
| A7033 |
Replacement nasal pillows |
193 |
192 |
$7K |
| E0562 |
Humidifier heated used w pap |
33 |
33 |
$5K |
| E0570 |
Nebulizer with compression |
281 |
275 |
$3K |
| A6402 |
Sterile gauze <= 16 sq in |
319 |
229 |
$1K |
| A6219 |
Gauze <= 16 sq in w/border |
19 |
12 |
$342.88 |
| A6403 |
Sterile gauze>16 <= 48 sq in |
16 |
12 |
$46.72 |