| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J7605 |
Arformoterol, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 15 micrograms |
4,160 |
3,434 |
$245K |
| J7606 |
Formoterol fumarate, inhalation solution, fda approved final product, non-compounded, administered through dme, unit dose form, 20 micrograms |
2,791 |
2,295 |
$192K |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
10,639 |
8,783 |
$171K |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
30,848 |
27,072 |
$131K |
| J7677 |
Revefenacin inhalation solution, fda-approved final product, non-compounded, administered through dme, 1 microgram |
782 |
547 |
$75K |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
15,792 |
13,079 |
$71K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
15,974 |
13,364 |
$64K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
12,120 |
10,908 |
$31K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
968 |
793 |
$21K |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
3,023 |
2,427 |
$11K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
151 |
150 |
$10K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
194 |
179 |
$8K |
| A7015 |
Aerosol mask, used with dme nebulizer |
2,876 |
2,589 |
$8K |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
8,016 |
7,227 |
$8K |
| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system |
129 |
106 |
$5K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
74 |
74 |
$2K |
| 99199 |
Unlisted special service, procedure or report |
143 |
137 |
$2K |
| J3490 |
Unclassified drugs |
97 |
86 |
$1K |
| G0333 |
Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary |
244 |
205 |
$862.03 |
| K0738 |
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing |
17 |
17 |
$578.35 |
| A4259 |
Lancets, per box of 100 |
42 |
40 |
$419.67 |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
251 |
227 |
$386.29 |
| E0570 |
Nebulizer, with compressor |
59 |
49 |
$224.09 |
| A4256 |
Normal, low and high calibrator solution / chips |
16 |
15 |
$50.33 |