| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,003 |
1,833 |
$46K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
134 |
129 |
$20K |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
174 |
173 |
$12K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
75 |
68 |
$12K |
| 0001A |
|
297 |
297 |
$10K |
| 0002A |
|
254 |
253 |
$10K |
| A4215 |
Needle, sterile, any size, each |
452 |
425 |
$7K |
| 91320 |
|
37 |
37 |
$4K |
| 90686 |
|
80 |
80 |
$2K |
| A4259 |
Lancets, per box of 100 |
660 |
625 |
$2K |
| 0004A |
|
30 |
30 |
$1K |
| 0003A |
|
30 |
29 |
$1K |
| 90480 |
|
41 |
41 |
$1K |
| 0031A |
|
20 |
20 |
$720.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
119 |
119 |
$564.99 |
| 0064A |
|
16 |
16 |
$520.00 |
| 0124A |
|
13 |
13 |
$480.00 |
| 0011A |
|
13 |
13 |
$480.00 |
| S8490 |
Insulin syringes (100 syringes, any size) |
12 |
12 |
$417.91 |
| 91300 |
|
434 |
410 |
$0.00 |
| 91312 |
|
13 |
13 |
$0.00 |
| 91301 |
|
44 |
44 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
16 |
16 |
$0.00 |