A4206 | Syringe with needle, sterile, 1 cc or less, each | |
A4207 | Syringe with needle, sterile 2 cc, each | |
A4208 | Syringe with needle, sterile 3 cc, each | |
A4209 | Syringe with needle, sterile 5 cc or greater, each | |
A4210 | Needle-free injection device, each | |
A4211 | Supplies for self-administered injections | |
A4212 | Non-coring needle or stylet with or without catheter | |
A4213 | Syringe, sterile, 20 cc or greater, each | |
A4215 | Needle, sterile, any size, each | |
A4216 | Sterile water, saline and/or dextrose, diluent/flush, 10 ml | |
A4217 | Sterile water/saline, 500 ml | |
A4218 | Sterile saline or water, metered dose dispenser, 10 ml | |
A4220 | Refill kit for implantable infusion pump | |
A4221 | Supplies for maintenance of non-insulin drug infusion catheter, per week (list drugs separately) | |
A4222 | Infusion supplies for external drug infusion pump, per cassette or bag (list drugs separately) | |
A4223 | Infusion supplies not used with external infusion pump, per cassette or bag (list drugs separately) | |
A4224 | Supplies for maintenance of insulin infusion catheter, per week | |
A4225 | Supplies for external insulin infusion pump, syringe type cartridge, sterile, each | |
A4230 | Infusion set for external insulin pump, non needle cannula type | |
A4231 | Infusion set for external insulin pump, needle type | |
A4232 | Syringe with needle for external insulin pump, sterile, 3 cc | |
A4233 | Replacement battery, alkaline (other than j cell), for use with medically necessary home blood glucose monitor owned by patient, each | |
A4234 | Replacement battery, alkaline, j cell, for use with medically necessary home blood glucose monitor owned by patient, each | |
A4235 | Replacement battery, lithium, for use with medically necessary home blood glucose monitor owned by patient, each | |
A4236 | Replacement battery, silver oxide, for use with medically necessary home blood glucose monitor owned by patient, each | |
A4244 | Alcohol or peroxide, per pint | |
A4245 | Alcohol wipes, per box | |
A4246 | Betadine or phisohex solution, per pint | |
A4247 | Betadine or iodine swabs/wipes, per box | |
A4248 | Chlorhexidine containing antiseptic, 1 ml | |
A4250 | Urine test or reagent strips or tablets (100 tablets or strips) | |
A4252 | Blood ketone test or reagent strip, each | |
A4253 | Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips | |
A4255 | Platforms for home blood glucose monitor, 50 per box | |
A4256 | Normal, low and high calibrator solution / chips | |
A4257 | Replacement lens shield cartridge for use with laser skin piercing device, each | |
A4258 | Spring-powered device for lancet, each | |
A4259 | Lancets, per box of 100 | |
A4261 | Cervical cap for contraceptive use | |
A4262 | Temporary, absorbable lacrimal duct implant, each | |
A4263 | Permanent, long term, non-dissolvable lacrimal duct implant, each | |
A4264 | Permanent implantable contraceptive intratubal occlusion device(s) and delivery system | |
A4265 | Paraffin, per pound | |
A4266 | Diaphragm for contraceptive use | |
A4267 | Contraceptive supply, condom, male, each | |
A4268 | Contraceptive supply, condom, female, each | |
A4270 | Disposable endoscope sheath, each | |
A4280 | Adhesive skin support attachment for use with external breast prosthesis, each | |
A4281 | Tubing for breast pump, replacement | |
A4282 | Adapter for breast pump, replacement | |
A4283 | Cap for breast pump bottle, replacement | |
A4284 | Breast shield and splash protector for use with breast pump, replacement | |
A4285 | Polycarbonate bottle for use with breast pump, replacement | |
A4286 | Locking ring for breast pump, replacement | |
A4290 | Sacral nerve stimulation test lead, each |