| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
719 |
686 |
$3K |
| J7613 |
Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg |
16 |
15 |
$97.87 |
| J7620 |
Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme |
14 |
12 |
$66.99 |
| A4259 |
Lancets, per box of 100 |
83 |
80 |
$34.40 |
| Q0513 |
Pharmacy dispensing fee for inhalation drug(s); per 30 days |
164 |
160 |
$0.00 |
| 0064A |
|
33 |
32 |
$0.00 |
| 0012A |
|
38 |
38 |
$0.00 |
| 0011A |
|
60 |
60 |
$0.00 |
| G0008 |
Administration of influenza virus vaccine |
18 |
18 |
$0.00 |