| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
1,735 |
1,603 |
$46K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
178 |
161 |
$23K |
| A4215 |
Needle, sterile, any size, each |
632 |
605 |
$11K |
| K1034 |
Provision of covid-19 test, nonprescription self-administered and self-collected use, fda approved, authorized or cleared, one test count |
129 |
129 |
$11K |
| 0012A |
|
139 |
139 |
$5K |
| 0011A |
|
156 |
156 |
$4K |
| 0001A |
|
95 |
95 |
$4K |
| 0002A |
|
84 |
84 |
$3K |
| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
13 |
12 |
$3K |
| 0064A |
|
58 |
56 |
$2K |
| 90686 |
|
85 |
84 |
$1K |
| 0004A |
|
29 |
29 |
$1K |
| A4259 |
Lancets, per box of 100 |
334 |
322 |
$1K |
| 0003A |
|
27 |
27 |
$1K |
| 0071A |
|
15 |
15 |
$600.00 |
| 90480 |
|
12 |
12 |
$480.00 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
85 |
84 |
$427.56 |
| 0134A |
|
12 |
12 |
$400.00 |
| S8490 |
Insulin syringes (100 syringes, any size) |
17 |
13 |
$362.40 |
| 91300 |
|
243 |
234 |
$0.00 |
| 91313 |
|
12 |
12 |
$0.00 |
| 91301 |
|
266 |
264 |
$0.00 |
| 91307 |
|
15 |
15 |
$0.00 |