| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
3,532 |
3,208 |
$76K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
276 |
255 |
$38K |
| A4215 |
Needle, sterile, any size, each |
1,868 |
1,708 |
$30K |
| S8490 |
Insulin syringes (100 syringes, any size) |
653 |
563 |
$11K |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
146 |
145 |
$10K |
| 0002A |
|
222 |
221 |
$9K |
| 0001A |
|
230 |
230 |
$9K |
| A4259 |
Lancets, per box of 100 |
1,329 |
1,274 |
$3K |
| 0011A |
|
90 |
90 |
$3K |
| 0012A |
|
69 |
69 |
$3K |
| 0064A |
|
59 |
59 |
$2K |
| 90686 |
|
101 |
101 |
$1K |
| 90480 |
|
29 |
29 |
$920.00 |
| E0607 |
Home blood glucose monitor |
24 |
24 |
$759.98 |
| 0124A |
|
18 |
18 |
$560.00 |
| 0004A |
|
16 |
15 |
$480.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
92 |
90 |
$351.21 |
| 91301 |
|
135 |
131 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
15 |
15 |
$0.00 |
| 91307 |
|
20 |
14 |
$0.00 |
| 91300 |
|
366 |
322 |
$0.00 |
| 91312 |
|
18 |
18 |
$0.00 |