| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
2,569 |
2,389 |
$108K |
| E0562 |
Humidifier, heated, used with positive airway pressure device |
1,527 |
1,382 |
$30K |
| A5512 |
For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each |
485 |
344 |
$24K |
| 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 |
489 |
345 |
$22K |
| A7034 |
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap |
479 |
466 |
$22K |
| E0570 |
Nebulizer, with compressor |
332 |
297 |
$16K |
| A7032 |
Cushion for use on nasal mask interface, replacement only, each |
302 |
292 |
$9K |
| A7035 |
Headgear used with positive airway pressure device |
456 |
439 |
$7K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
204 |
197 |
$6K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
783 |
746 |
$3K |
| A7037 |
Tubing used with positive airway pressure device |
199 |
195 |
$2K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
532 |
511 |
$2K |
| A7039 |
Filter, non disposable, used with positive airway pressure device |
121 |
117 |
$557.08 |
| A7031 |
Face mask interface, replacement for full face mask, each |
13 |
12 |
$380.86 |
| A7004 |
Small volume nonfiltered pneumatic nebulizer, disposable |
119 |
119 |
$255.04 |
| 0013A |
|
15 |
15 |
$0.00 |
| 0003A |
|
14 |
14 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
29 |
28 |
$0.00 |