| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| A4253 |
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips |
24,232 |
23,808 |
$2.01M |
| A4259 |
Lancets, per box of 100 |
23,584 |
23,184 |
$301K |
| A4206 |
Syringe with needle, sterile, 1 cc or less, each |
7,365 |
7,258 |
$209K |
| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
149 |
143 |
$58K |
| A4256 |
Normal, low and high calibrator solution / chips |
6,316 |
6,157 |
$55K |
| A4230 |
Infusion set for external insulin pump, non needle cannula type |
297 |
289 |
$50K |
| E0570 |
Nebulizer, with compressor |
746 |
665 |
$49K |
| E0607 |
Home blood glucose monitor |
839 |
802 |
$47K |
| A4245 |
Alcohol wipes, per box |
19,632 |
19,311 |
$45K |
| A4258 |
Spring-powered device for lancet, each |
2,372 |
2,287 |
$32K |
| A4221 |
Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) |
1,206 |
398 |
$23K |
| A7005 |
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable |
723 |
649 |
$13K |
| A4232 |
Syringe with needle for external insulin pump, sterile, 3 cc |
297 |
289 |
$12K |
| A4235 |
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each |
2,124 |
1,407 |
$4K |
| A6530 |
Gradient compression stocking, below knee, 18-30 mmhg, each |
19 |
13 |
$1K |