| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
126 |
115 |
$3.90 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
101 |
89 |
$0.00 |
| 90686 |
|
121 |
70 |
$0.00 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
84 |
82 |
$0.00 |
| G0333 |
Pharmacy dispensing fee for inhalation drug(s); initial 30-day supply as a beneficiary |
16 |
16 |
$0.00 |
| 91322 |
|
42 |
42 |
$0.00 |