| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| H2010 |
Comprehensive medication services, per 15 minutes |
8,744 |
162 |
$42K |
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
918 |
913 |
$37K |
| E0601 |
Continuous positive airway pressure (cpap) device |
746 |
746 |
$24K |
| A9901 |
Dme delivery, set up, and/or dispensing service component of another hcpcs code |
1,057 |
1,029 |
$18K |
| E0570 |
Nebulizer, with compressor |
54 |
54 |
$6K |
| 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 |
317 |
314 |
$4K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
1,204 |
1,196 |
$4K |
| A7035 |
Headgear used with positive airway pressure device |
129 |
129 |
$2K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
42 |
42 |
$1K |
| A5500 |
For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe |
34 |
29 |
$1K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
57 |
56 |
$1K |
| A7030 |
Full face mask used with positive airway pressure device, each |
12 |
12 |
$939.86 |
| S9430 |
Pharmacy compounding and dispensing services |
166 |
166 |
$704.00 |
| A7031 |
Face mask interface, replacement for full face mask, each |
24 |
24 |
$651.64 |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
12 |
12 |
$389.47 |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
13 |
13 |
$50.12 |
| 90688 |
|
34 |
34 |
$0.00 |
| 90674 |
|
19 |
19 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
131 |
131 |
$0.00 |
| 90686 |
|
21 |
21 |
$0.00 |