| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
541 |
496 |
$10K |
| 0001A |
|
386 |
351 |
$9K |
| 0002A |
|
231 |
228 |
$7K |
| 91322 |
|
16 |
14 |
$1K |
| 90688 |
|
49 |
49 |
$953.14 |
| 90686 |
|
53 |
53 |
$712.08 |
| 0011A |
|
13 |
13 |
$520.00 |
| 0124A |
|
27 |
27 |
$468.20 |
| A4215 |
Needle, sterile, any size, each |
30 |
29 |
$458.70 |
| 90674 |
|
16 |
16 |
$380.29 |
| 90471 |
Immunization administration (includes percutaneous, intradermal, subcutaneous, or intramuscular injections), 1 vaccine |
124 |
123 |
$361.39 |
| 90480 |
|
24 |
22 |
$289.87 |
| 90685 |
|
15 |
14 |
$249.68 |
| 91312 |
|
13 |
13 |
$8.00 |
| G0008 |
Administration of influenza virus vaccine |
14 |
14 |
$0.00 |
| 91301 |
|
13 |
13 |
$0.00 |
| 91300 |
|
539 |
467 |
$0.00 |