| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,347 |
2,206 |
$4K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
42 |
42 |
$627.95 |
| A4256 |
Normal, low and high calibrator solution / chips |
1,422 |
1,343 |
$493.78 |
| A4259 |
Lancets, per box of 100 |
1,880 |
1,769 |
$488.80 |
| A4235 |
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each |
937 |
926 |
$336.74 |
| A4258 |
Spring-powered device for lancet, each |
450 |
444 |
$218.71 |
| A4595 |
Electrical stimulator supplies, 2 lead, per month, (e.g., tens, nmes) |
69 |
68 |
$93.05 |