| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0570 |
Nebulizer with compression |
3,111 |
2,420 |
$192K |
| A4554 |
Disposable underpads |
2,120 |
1,932 |
$124K |
| T4526 |
Adult size pull-on med |
1,249 |
1,151 |
$116K |
| T4527 |
Adult size pull-on lg |
430 |
405 |
$44K |
| A4627 |
Spacer bag/reservoir |
708 |
624 |
$33K |
| E1390 |
Oxygen concentrator |
909 |
626 |
$29K |
| E0601 |
Cont airway pressure device |
606 |
457 |
$26K |
| T4528 |
Adult size pull-on xl |
276 |
262 |
$24K |
| A7005 |
Nondisposable nebulizer set |
849 |
741 |
$19K |
| T4534 |
Youth size pull-on |
40 |
37 |
$5K |
| A4927 |
Non-sterile gloves |
153 |
145 |
$4K |
| A7015 |
Aerosol mask used w nebulize |
2,401 |
2,027 |
$3K |
| E0431 |
Portable gaseous 02 |
642 |
429 |
$3K |
| A7003 |
Nebulizer administration set |
1,514 |
1,272 |
$3K |
| Q0513 |
Disp fee inhal drugs/30 days |
57 |
52 |
$500.63 |
| L8000 |
Mastectomy bra |
48 |
27 |
$480.39 |
| A4253 |
Blood glucose/reagent strips |
470 |
434 |
$203.89 |
| A7037 |
Pos airway pressure tubing |
12 |
12 |
$176.56 |
| A7035 |
Pos airway press headgear |
14 |
13 |
$159.20 |
| A4259 |
Lancets per box |
362 |
329 |
$25.98 |