| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,990 |
1,863 |
$42K |
| 0002A |
|
415 |
412 |
$15K |
| A4215 |
Needle, sterile, any size, each |
810 |
778 |
$14K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
133 |
125 |
$14K |
| 0001A |
|
418 |
418 |
$14K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
148 |
140 |
$12K |
| 0004A |
|
121 |
120 |
$4K |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
60 |
60 |
$4K |
| 91320 |
|
35 |
35 |
$4K |
| 0124A |
|
55 |
55 |
$2K |
| 90480 |
|
59 |
59 |
$2K |
| 90686 |
|
156 |
155 |
$2K |
| 0072A |
|
33 |
33 |
$1K |
| 0071A |
|
31 |
31 |
$1K |
| A9276 |
Sensor; invasive (e.g., subcutaneous), disposable, for use with non-durable medical equipment interstitial continuous glucose monitoring system, one unit = 1 day supply |
12 |
12 |
$985.32 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
131 |
131 |
$554.81 |
| 0054A |
|
12 |
12 |
$480.00 |
| 0064A |
|
14 |
14 |
$440.00 |
| A4259 |
Lancets, per box of 100 |
127 |
122 |
$377.80 |
| 0011A |
|
19 |
19 |
$237.16 |
| 91307 |
|
74 |
70 |
$0.00 |
| 91305 |
|
37 |
35 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
43 |
43 |
$0.00 |
| 91300 |
|
700 |
634 |
$0.00 |
| 91312 |
|
51 |
51 |
$0.00 |
| 90662 |
|
23 |
23 |
$0.00 |