| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E0601 |
Continuous positive airway pressure (cpap) device |
5,894 |
3,813 |
$192K |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,348 |
2,022 |
$86K |
| A4554 |
Disposable underpads, all sizes |
1,631 |
1,499 |
$52K |
| T4528 |
Adult sized disposable incontinence product, protective underwear/pull-on, extra large size, each |
515 |
491 |
$47K |
| E0570 |
Nebulizer, with compressor |
1,673 |
1,315 |
$40K |
| T4535 |
Disposable liner/shield/guard/pad/undergarment, for incontinence, each |
336 |
317 |
$21K |
| A4259 |
Lancets, per box of 100 |
1,870 |
1,597 |
$15K |
| T4527 |
Adult sized disposable incontinence product, protective underwear/pull-on, large size, each |
120 |
115 |
$10K |
| T4526 |
Adult sized disposable incontinence product, protective underwear/pull-on, medium size, each |
72 |
70 |
$7K |
| A4927 |
Gloves, non-sterile, per 100 |
444 |
417 |
$5K |
| A7038 |
Filter, disposable, used with positive airway pressure device |
799 |
524 |
$2K |
| A5120 |
Skin barrier, wipes or swabs, each |
374 |
245 |
$2K |
| 0001A |
|
40 |
37 |
$2K |
| 0011A |
|
176 |
171 |
$2K |
| 0002A |
|
24 |
24 |
$2K |
| E0470 |
Respiratory assist device, bi-level pressure capability, without backup rate feature, used with noninvasive interface, e.g., nasal or facial mask (intermittent assist device with continuous positive airway pressure device) |
21 |
12 |
$2K |
| 0012A |
|
144 |
143 |
$1K |
| A4604 |
Tubing with integrated heating element for use with positive airway pressure device |
127 |
78 |
$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 |
24 |
12 |
$1K |
| 0031A |
|
109 |
109 |
$820.00 |
| A7030 |
Full face mask used with positive airway pressure device, each |
21 |
12 |
$366.75 |
| 90674 |
|
42 |
40 |
$344.10 |
| G0008 |
Administration of influenza virus vaccine |
108 |
104 |
$293.55 |
| A7035 |
Headgear used with positive airway pressure device |
16 |
13 |
$7.29 |