| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
254 |
240 |
$5K |
| A4927 |
Gloves, non-sterile, per 100 |
120 |
114 |
$1K |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
25 |
25 |
$15.52 |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
38 |
37 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
30 |
25 |
$0.00 |
| 0011A |
|
28 |
27 |
$0.00 |