| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 0650 |
Inj, levothyroxine, hikma |
2,082 |
263 |
$1.15M |
| 0651 |
|
939 |
262 |
$858K |
| Q5001 |
Hospice or home hlth in home |
581 |
210 |
$775K |
| G0300 |
Hhs/hospice of lpn ea 15 min |
2,580 |
239 |
$44K |
| G0299 |
Hhs/hospice of rn ea 15 min |
820 |
217 |
$18K |
| G0155 |
Hhcp-svs of csw,ea 15 min |
239 |
153 |
$8K |
| E1390 |
Oxygen concentrator |
428 |
262 |
$6K |
| E0431 |
Portable gaseous 02 |
403 |
250 |
$5K |
| E0570 |
Nebulizer with compression |
191 |
129 |
$2K |
| A4615 |
Cannula nasal |
188 |
122 |
$1K |
| A7003 |
Nebulizer administration set |
173 |
106 |
$1K |
| A7015 |
Aerosol mask used w nebulize |
62 |
25 |
$284.91 |
| E1353 |
Oxygen supplies regulator |
12 |
12 |
$168.04 |