| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,192 |
1,168 |
$14K |
| A4259 |
Lancets, per box of 100 |
1,136 |
1,112 |
$1K |
| E0601 |
Continuous positive airway pressure (cpap) device |
130 |
130 |
$109.52 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
349 |
339 |
$42.90 |
| E0570 |
Nebulizer, with compressor |
43 |
43 |
$35.00 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
123 |
123 |
$32.30 |
| K0001 |
Standard wheelchair |
289 |
287 |
$23.54 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
262 |
262 |
$11.97 |
| K0195 |
Elevating leg rests, pair (for use with capped rental wheelchair base) |
102 |
101 |
$10.63 |
| E0973 |
Wheelchair accessory, adjustable height, detachable armrest, complete assembly, each |
37 |
37 |
$5.96 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
349 |
339 |
$3.38 |
| A7015 |
Aerosol mask, used with dme nebulizer |
349 |
339 |
$2.48 |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
83 |
83 |
$0.00 |
| A7035 |
Headgear used with positive airway pressure device |
22 |
22 |
$0.00 |
| K0006 |
Heavy duty wheelchair |
15 |
15 |
$0.00 |
| K0003 |
Lightweight wheelchair |
27 |
27 |
$0.00 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
24 |
24 |
$0.00 |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
17 |
17 |
$0.00 |
| E0260 |
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress |
403 |
403 |
$0.00 |
| A4452 |
Tape, waterproof, per 18 square inches |
17 |
17 |
$0.00 |
| K0739 |
Repair or nonroutine service for durable medical equipment other than oxygen equipment requiring the skill of a technician, labor component, per 15 minutes |
12 |
12 |
$0.00 |
| A4406 |
Ostomy skin barrier, pectin-based, paste, per ounce |
14 |
14 |
$0.00 |
| A7038 |
Filter, disposable, used with positive airway pressure device |
16 |
16 |
$0.00 |
| E1226 |
Wheelchair accessory, manual fully reclining back, (recline greater than 80 degrees), each |
13 |
13 |
$0.00 |
| A6260 |
Wound cleansers, any type, any size |
15 |
15 |
$0.00 |
| A4615 |
Cannula, nasal |
13 |
12 |
$0.00 |
| E0303 |
Hospital bed, heavy duty, extra wide, with weight capacity greater than 350 pounds, but less than or equal to 600 pounds, with any type side rails, with mattress |
13 |
13 |
$0.00 |
| E0277 |
Powered pressure-reducing air mattress |
18 |
18 |
$0.00 |
| E0135 |
Walker, folding (pickup), adjustable or fixed height |
14 |
14 |
$0.00 |
| E0181 |
Powered pressure reducing mattress overlay/pad, alternating, with pump, includes heavy duty |
46 |
46 |
$0.00 |
| A7030 |
Full face mask used with positive airway pressure device, each |
14 |
14 |
$0.00 |
| A4371 |
Ostomy skin barrier, powder, per oz |
14 |
14 |
$0.00 |
| E0630 |
Patient lift, hydraulic or mechanical, includes any seat, sling, strap(s) or pad(s) |
26 |
26 |
$0.00 |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
57 |
57 |
$0.00 |
| A4414 |
Ostomy skin barrier, with flange (solid, flexible or accordion), without built-in convexity, 4 x 4 inches or smaller, each |
16 |
16 |
$0.00 |
| A7037 |
Tubing used with positive airway pressure device |
26 |
26 |
$0.00 |
| E0143 |
Walker, folding, wheeled, adjustable or fixed height |
17 |
17 |
$0.00 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
12 |
12 |
$0.00 |
| J7644 |
Ipratropium bromide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, per milligram |
89 |
89 |
$0.00 |
| A4456 |
Adhesive remover, wipes, any type, each |
16 |
16 |
$0.00 |
| J7626 |
Budesonide, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose form, up to 0.5 mg |
15 |
15 |
$0.00 |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
14 |
14 |
$0.00 |
| E1038 |
Transport chair, adult size, patient weight capacity up to and including 300 pounds |
42 |
41 |
$0.00 |
| E0240 |
Bath/shower chair, with or without wheels, any size |
22 |
22 |
$0.00 |
| E1392 |
Portable oxygen concentrator, rental |
13 |
13 |
$0.00 |
| E0156 |
Seat attachment, walker |
15 |
15 |
$0.00 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
13 |
13 |
$0.00 |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
60 |
60 |
$0.00 |