| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 00731 |
|
761 |
460 |
$38K |
| 00811 |
|
454 |
287 |
$21K |
| A4222 |
Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) |
1,649 |
1,143 |
$20K |
| 00812 |
|
339 |
207 |
$15K |
| 93040 |
|
1,861 |
1,221 |
$14K |
| 00813 |
|
159 |
97 |
$9K |
| A4670 |
Automatic blood pressure monitor |
1,555 |
993 |
$5K |
| E0780 |
Ambulatory infusion pump, mechanical, reusable, for infusion less than 8 hours |
1,485 |
967 |
$4K |
| E1399 |
Durable medical equipment, miscellaneous |
5,059 |
1,062 |
$3K |
| A4628 |
Oral and/or oropharyngeal suction catheter, each |
1,607 |
1,102 |
$2K |
| E1353 |
Regulator |
1,565 |
962 |
$1K |
| A4649 |
Surgical supply; miscellaneous |
215 |
150 |
$1K |
| E0424 |
Stationary compressed gaseous oxygen system, rental; includes container, contents, regulator, flowmeter, humidifier, nebulizer, cannula or mask, and tubing |
1,499 |
949 |
$1K |
| E1354 |
Oxygen accessory, wheeled cart for portable cylinder or portable concentrator, any type, replacement only, each |
1,565 |
964 |
$932.87 |
| E0445 |
Oximeter device for measuring blood oxygen levels non-invasively |
121 |
77 |
$791.91 |
| E0600 |
Respiratory suction pump, home model, portable or stationary, electric |
1,507 |
970 |
$715.65 |
| A4208 |
Syringe with needle, sterile 3 cc, each |
1,877 |
1,183 |
$281.85 |
| J2704 |
Injection, propofol, 10 mg |
2,269 |
976 |
$150.65 |
| J7643 |
Glycopyrrolate, inhalation solution, compounded product, administered through dme, unit dose form, per milligram |
175 |
131 |
$107.47 |
| 94760 |
|
2,117 |
1,079 |
$106.02 |
| R0076 |
Transportation of portable ekg to facility or location, per patient |
1,557 |
957 |
$70.55 |
| J1885 |
Injection, ketorolac tromethamine, per 15 mg |
130 |
108 |
$69.10 |
| E0617 |
External defibrillator with integrated electrocardiogram analysis |
1,655 |
920 |
$68.44 |
| J7040 |
Infusion, normal saline solution, sterile (500 ml = 1 unit) |
111 |
89 |
$53.33 |
| J3010 |
Injection, fentanyl citrate, 0.1 mg |
160 |
128 |
$44.64 |
| J2001 |
Injection, lidocaine hcl for intravenous infusion, 10 mg |
1,661 |
997 |
$32.99 |
| J2405 |
Injection, ondansetron hydrochloride, per 1 mg |
170 |
138 |
$29.27 |