| E2101 |
Blood glucose monitor with integrated lancing/blood sample Non-Facility |
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| E2101 |
Bld glucose monitor w lance |
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| J3490 |
Finger Stick Blood Glucose Stp |
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| J3490 |
Glucose Oral Gel 15gm |
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| A4271 |
Integrated lancing and blood sample testing cartridges for home blood glucose monitor, per 50 tests |
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| A4239 |
Supply allowance for non-adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
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| E2104 |
Home blood glucose monitor for use with integrated lancing/blood sample testing cartridge |
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| A4226 |
Supplies for maintenance of insulin infusion pump with dosage rate adjustment using therapeutic continuous glucose sensing, per week |
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| E2103 |
Non-adjunctive, non-implanted continuous glucose monitor or receiver |
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| A4238 |
Supply allowance for adjunctive, non-implanted continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service |
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| E2102 |
Adjunctive, non-implanted continuous glucose monitor or receiver |
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| E0787 |
External ambulatory infusion pump, insulin, dosage rate adjustment using therapeutic continuous glucose sensing |
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| A4235 |
Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each Non-Facility |
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| A4236 |
Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each Non-Facility |
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| K0554 |
Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system Non-Facility |
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| A4233 |
Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each Non-Facility |
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| K0553 |
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service Non-Facility |
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| A4234 |
Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each Non-Facility |
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