| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
3,126 |
2,986 |
$75K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
259 |
257 |
$28K |
| A4215 |
Needle, sterile, any size, each |
1,308 |
1,251 |
$22K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
166 |
158 |
$18K |
| 0012A |
|
325 |
325 |
$12K |
| 0001A |
|
307 |
306 |
$12K |
| 0011A |
|
356 |
352 |
$11K |
| 0002A |
|
263 |
262 |
$10K |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
106 |
105 |
$6K |
| 0064A |
|
132 |
130 |
$5K |
| A4259 |
Lancets, per box of 100 |
1,406 |
1,367 |
$4K |
| 0004A |
|
92 |
91 |
$4K |
| 91322 |
|
29 |
29 |
$3K |
| 90686 |
|
160 |
160 |
$2K |
| 90480 |
|
48 |
48 |
$2K |
| 0031A |
|
36 |
36 |
$1K |
| 0124A |
|
26 |
26 |
$1K |
| 0071A |
|
20 |
20 |
$800.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
155 |
155 |
$778.77 |
| 0134A |
|
12 |
12 |
$400.00 |
| S8490 |
Insulin syringes (100 syringes, any size) |
12 |
12 |
$322.98 |
| E0607 |
Home blood glucose monitor |
12 |
12 |
$295.10 |
| 91301 |
|
653 |
638 |
$0.00 |
| 91305 |
|
18 |
16 |
$0.00 |
| 91307 |
|
20 |
20 |
$0.00 |
| 91300 |
|
610 |
557 |
$0.00 |
| 91312 |
|
26 |
26 |
$0.00 |