| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate |
1,417 |
1,085 |
$75K |
| E0431 |
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing |
584 |
422 |
$3K |
| E0601 |
Continuous positive airway pressure (cpap) device |
150 |
87 |
$2K |
| 0001A |
|
35 |
31 |
$2K |
| E0570 |
Nebulizer, with compressor |
311 |
204 |
$1K |
| 0002A |
|
25 |
21 |
$1K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
48 |
37 |
$86.78 |
| 90674 |
|
63 |
38 |
$70.72 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
48 |
34 |
$66.50 |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
27 |
27 |
$49.94 |
| A4259 |
Lancets, per box of 100 |
12 |
12 |
$1.41 |
| G0008 |
Administration of influenza virus vaccine |
32 |
12 |
$0.00 |
| 91300 |
|
68 |
52 |
$0.00 |