| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7605 |
Arformoterol non-comp unit |
4,160 |
3,434 |
$245K |
| J7606 |
Formoterol fumarate, inh |
2,791 |
2,295 |
$192K |
| J7626 |
Budesonide non-comp unit |
10,639 |
8,783 |
$171K |
| Q0513 |
Disp fee inhal drugs/30 days |
30,848 |
27,072 |
$131K |
| J7677 |
Revefenacin inh non-com 1mcg |
782 |
547 |
$75K |
| J7620 |
Albuterol ipratrop non-comp |
15,792 |
13,079 |
$71K |
| J7613 |
Albuterol non-comp unit |
15,974 |
13,364 |
$64K |
| A7003 |
Nebulizer administration set |
12,120 |
10,908 |
$31K |
| K0553 |
Ther cgm supply allowance |
968 |
793 |
$21K |
| J7644 |
Ipratropium bromide non-comp |
3,023 |
2,427 |
$11K |
| E1390 |
Oxygen concentrator |
151 |
150 |
$10K |
| A4253 |
Blood glucose/reagent strips |
194 |
179 |
$8K |
| A7015 |
Aerosol mask used w nebulize |
2,876 |
2,589 |
$8K |
| A7004 |
Disposable nebulizer sml vol |
8,016 |
7,227 |
$8K |
| K0554 |
Ther cgm receiver/monitor |
129 |
106 |
$5K |
| E0431 |
Portable gaseous 02 |
74 |
74 |
$2K |
| 99199 |
|
143 |
137 |
$2K |
| J3490 |
Drugs unclassified injection |
97 |
86 |
$1K |
| G0333 |
Dispense fee initial 30 day |
244 |
205 |
$862.03 |
| K0738 |
Portable gas oxygen system |
17 |
17 |
$578.35 |
| A4259 |
Lancets per box |
42 |
40 |
$419.67 |
| A7005 |
Nondisposable nebulizer set |
251 |
227 |
$386.29 |
| E0570 |
Nebulizer with compression |
59 |
49 |
$224.09 |
| A4256 |
Calibrator solution/chips |
16 |
15 |
$50.33 |