| Code | Description | Claims | Beneficiaries | Total Paid |
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
2,569 |
2,290 |
$67K |
| A4215 |
Needle, sterile, any size, each |
696 |
640 |
$26K |
| E1399 |
Durable medical equipment, miscellaneous |
346 |
225 |
$19K |
| 0002A |
|
372 |
235 |
$11K |
| 0001A |
|
409 |
268 |
$11K |
| 91320 |
|
87 |
72 |
$8K |
| A4627 |
Spacer, bag or reservoir, with or without mask, for use with metered dose inhaler |
136 |
132 |
$5K |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
321 |
306 |
$5K |
| A4259 |
Lancets, per box of 100 |
434 |
401 |
$4K |
| 90636 |
|
54 |
52 |
$4K |
| 90480 |
|
75 |
72 |
$3K |
| 90715 |
|
32 |
32 |
$2K |
| 90674 |
|
57 |
57 |
$1K |
| 90686 |
|
126 |
121 |
$1K |
| 90661 |
|
24 |
24 |
$810.70 |
| 90472 |
Immunization administration, each additional vaccine (list separately) |
96 |
77 |
$655.20 |
| 0004A |
|
23 |
13 |
$494.16 |
| 0003A |
|
24 |
13 |
$494.16 |
| 90656 |
|
19 |
19 |
$402.30 |
| E0607 |
Home blood glucose monitor |
14 |
13 |
$359.28 |
| 91305 |
|
38 |
33 |
$0.00 |
| 91300 |
|
1,028 |
606 |
$0.00 |