| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,453 |
1,510 |
$35K |
| A4259 |
Lancets, per box of 100 |
2,408 |
1,493 |
$5K |
| A4245 |
Alcohol wipes, per box |
431 |
398 |
$618.54 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
1,411 |
633 |
$350.15 |
| A7003 |
Administration set, with small volume nonfiltered pneumatic nebulizer, disposable |
1,501 |
628 |
$172.65 |
| A7015 |
Aerosol mask, used with dme nebulizer |
1,581 |
645 |
$84.26 |
| A4258 |
Spring-powered device for lancet, each |
43 |
14 |
$44.16 |
| A4256 |
Normal, low and high calibrator solution / chips |
444 |
225 |
$38.02 |
| 91320 |
|
18 |
14 |
$0.00 |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
25 |
12 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
41 |
38 |
$0.00 |