| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
134,251 |
124,288 |
$6.85M |
| A4215 |
Needle, sterile, any size, each |
35,439 |
30,447 |
$1.64M |
| A4259 |
Lancets, per box of 100 |
130,302 |
120,841 |
$1.46M |
| 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 |
22,651 |
15,186 |
$1.33M |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
4,892 |
4,259 |
$594K |
| E0607 |
Home blood glucose monitor |
9,933 |
9,002 |
$567K |
| A5514 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
13,031 |
7,247 |
$518K |
| A4256 |
Normal, low and high calibrator solution / chips |
75,910 |
68,462 |
$444K |
| S8490 |
Insulin syringes (100 syringes, any size) |
15,536 |
13,274 |
$288K |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
13,344 |
12,869 |
$284K |
| A5513 |
For diabetics only, multiple density insert, custom molded from model of patient's foot, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
7,992 |
6,476 |
$278K |
| A4245 |
Alcohol wipes, per box |
55,775 |
48,276 |
$128K |
| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
548 |
486 |
$69K |
| A4258 |
Spring-powered device for lancet, each |
6,780 |
6,045 |
$40K |
| A4250 |
Urine test or reagent strips or tablets (100 tablets or strips) |
1,341 |
1,203 |
$18K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
63 |
53 |
$6K |
| K0903 |
For diabetics only, multiple density insert, made by direct carving with cam technology from a rectified cad model created from a digitized scan of the patient, total contact with patient's foot, including arch, base layer minimum of 3/16 inch material of shore a 35 durometer (or higher), includes arch filler and other shaping material, custom fabricated, each |
1,068 |
1,056 |
$0.00 |